Organization
MOSAIC COMMUNITY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF RICHARDSON LCSW-C (EXECUTIVE DIRECTOR)
(410) 453-9553
Entity
Organization
Contact information
Practice address
2225 N CHARLES ST, BALTIMORE, MD 21218-5778
(410) 366-4360
(410) 308-8926
Mailing address
849 FAIRMOUNT AVE FL 5, TOWSON, MD 21286-2624
(410) 382-8111
(443) 612-1488
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
371331806
—
MD
Enumeration date
05/25/2010
Last updated
01/18/2022
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