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General NPI Number Information
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NPI Number | 1487702098
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Entity Type | Organization
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Legal Business Name | MOSAIC COMMUNITY SERVICES MEDICAL DAY
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 7 BLOOMSBURY AVE
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City | CATONSVILLE
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State | MD
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Zip | 21228-4641
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Country | US
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Telephone | 410-453-9553
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Fax |
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Provider Business Mailing Address
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Address Line | 1925 GREENSPRING DR
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City | TIMONIUM
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State | MD
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Zip | 21093-4128
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Country | US
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Telephone | 410-453-9553
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. JEFF RICHARDSON
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Credential | LCSW-C
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Telephone | 410-453-9553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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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 | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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