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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