Organization
MOSAIC COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY RICHARDSON (EXECUTIVE DIRECTOR)
(410) 453-9553
Entity
Organization
Contact information
Practice address
9201 PHILADELPHIA RD, ROSEDALE, MD 21237
(410) 285-8157
(410) 285-8298
Mailing address
1925 GREENSPRING DR, TIMONIUM, MD 21093-4128
(410) 453-9553
(410) 308-8926
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
100406
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418938800
—
MD
Enumeration date
06/24/2008
Last updated
06/25/2018
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