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General NPI Number Information
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NPI Number | 1649895426
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Entity Type | Organization
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Legal Business Name | MOSAICS PUBLIC SCHOOL INC.
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 06/08/2020
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Provider Practice Location Address
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Address Line | 3121 LINCOLN RD
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City | CALDWELL
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State | ID
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Zip | 83605-8171
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Country | US
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Telephone | 208-402-8899
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Fax | 208-606-3527
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Provider Business Mailing Address
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Address Line | 1010 W JEFFERSON ST
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City | BOISE
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State | ID
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Zip | 83702-5445
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Country | US
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Telephone | 208-402-8899
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Fax | 208-606-3527
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Authorized Official
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Title or Position | FOUNDER
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Name | ANTHONY HASKETT
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Credential |
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Telephone | 208-402-8899
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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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