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General NPI Number Information
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NPI Number | 1063216661
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Entity Type | Organization
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Legal Business Name | MOSAIC HEALTH COLLECTIVE LLC
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Dates
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Enumeration Date | 04/02/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 605 AUSTIN AVE
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City | WACO
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State | TX
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Zip | 76701-2048
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Country | US
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Telephone | 817-937-0490
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Fax |
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Provider Business Mailing Address
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Address Line | 605 AUSTIN AVE
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City | WACO
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State | TX
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Zip | 76701-2048
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Country | US
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Telephone | 817-937-0490
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Fax |
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Authorized Official
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Title or Position | OWNER/CEO
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Name | VELONDRIA DEANNE BURSEY
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Credential | RN
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Telephone | 817-937-0490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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