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
102 W PARK ST, FOREST CITY, IA 50436-2132
(641) 585-3050
(641) 585-3939
Mailing address
102 W PARK ST, FOREST CITY, IA 50436-2132
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/08/2012
Last updated
10/06/2023
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