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General NPI Number Information
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NPI Number | 1417103649
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Entity Type | Organization
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Legal Business Name | MOSAIC FAMILY COUNSELING CENTER, INC.
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 6200 AURORA AVE STE 305E
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City | URBANDALE
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State | IA
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Zip | 50322-2863
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Country | US
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Telephone | 515-724-8920
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Fax | 712-545-2900
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Provider Business Mailing Address
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Address Line | 3705 GRAND AVE SUITE 100
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City | DES MOINES
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State | IA
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Zip | 50312-2805
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Country | US
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Telephone | 515-724-8920
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Fax | 888-771-3225
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Authorized Official
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Title or Position | CEO
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Name | KENYA ROCHA
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Credential |
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Telephone | 515-771-3672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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