Organization
MOSIAC
Active
Other names
Mosaic
Organization subpart
No
Provider details
NPI number
Authorized official
JERI SOLE (DIRECTOR OF BILLING)
(402) 896-5827
Entity
Organization
Contact information
Practice address
1044 23 RD, AXTELL, NE 68924-3679
(402) 896-5827
Mailing address
4980 S 118TH ST, OMAHA, NE 68137-2200
(402) 896-5827
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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