Organization
MOSAIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT HOFFMAN (SENIOR VP & CHIEF FINANCIAL OFFICER)
(402) 896-3884
Entity
Organization
Contact information
Practice address
718 S 13TH ST, NEVADA, IA 50201-2435
(641) 585-5451
Mailing address
11141 AURORA, URBANDALE, IA 50322-0000
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
03/09/2012
Last updated
06/11/2020
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