Organization
MOSAIC
Active
Organization
MOSAIC
Active
Other names
Mosaic of the Southwest
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT HOFFMAN (SENIOR VP AND CHIEF FINANCIAL OFFIC)
(402) 896-3884
Entity
Organization
Contact information
Practice address
2929 N 44TH ST STE 300, PHOENIX, AZ 85018-7278
(602) 864-6030
(602) 864-1513
Mailing address
4980 S 118TH ST, OMAHA, NE 68137-2200
(402) 698-9812
(402) 896-1511
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
866668
—
AZ
05
—
DDD704011
—
AZ
Enumeration date
03/25/2024
Last updated
03/25/2024
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