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NPI Code Detail

MEDICARE: MOSAIC MENTAL WELLNESS LLC

MEDICARE: MOSAIC MENTAL WELLNESS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1891348710
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOSAIC MENTAL WELLNESS LLC
Provider Business Mailing Address
First Line : 100 S MAIN ST STE 505
Second Line :
City : WICHITA
State : KS
Zip : 67202-3738
Country : US
Telephone Number : 316-688-8390
Fax Number : 316-867-1718
Provider Business Practice Location Address
First Line : 100 S MAIN ST STE 505
Second Line :
City : WICHITA
State : KS
Zip : 67202-3738
Country : US
Telephone Number : 316-688-8390
Fax Number : 316-867-1718
Authorized Official
Title or Position : CO-OWNER
Name : JOSEPHINE OLDHAM
Credential : LSCSW
Telephone Number : 316-685-8390
Provider Enumeration Date : 07/19/2019
Last Update Date : 12/10/2024

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Directions to “MOSAIC MENTAL WELLNESS LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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