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General NPI Number Information
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NPI Number | 1144091554
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Entity Type | Organization
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Legal Business Name | MOSAIC MENTAL HEALTHCARE
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 616 E 63RD ST STE 204
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City | KANSAS CITY
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State | MO
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Zip | 64110-3371
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Country | US
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Telephone | 816-200-0560
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Fax |
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Provider Business Mailing Address
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Address Line | 616 E 63RD ST STE 204
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City | KANSAS CITY
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State | MO
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Zip | 64110-3371
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALEXANDRA ROSS
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Credential |
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Telephone | 417-317-2251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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