Organization
MOSAIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT HOFFMAN (CHIEF FINANCIAL OFFICER)
(402) 896-3884
Entity
Organization
Contact information
Practice address
734 MAIN ST, GRAND JUNCTION, CO 81501-3598
(970) 245-0519
(970) 241-3526
Mailing address
4980 S 118TH ST, OMANA, NE 68137-2220
(402) 896-3884
(402) 894-4780
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
376J00000X
Homemaker
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22952756
—
CO
05
—
9000143330
—
CO
Enumeration date
04/11/2007
Last updated
11/13/2024
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