Organization
MOSAIC COMMUNITY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY RICHARDSON LCSW-C (CHIEF EXECUTIVE OFFICER)
(410) 453-9553
Entity
Organization
Contact information
Practice address
20 WINTERS LN, CATONSVILLE, MD 21228-4432
(410) 747-4492
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
—
371331804
—
MD
Enumeration date
01/29/2008
Last updated
01/18/2022
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