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1053463992

NPI Code Detail

MEDICARE: MOSAIC

MEDICARE: MOSAIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility	770674	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053463992
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSAIC

Provider Business Mailing Address
First Line	:	4980 S 118TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-2220
Country	:	US
Telephone Number	:	402-896-3884
Fax Number	:	402-894-4780

Provider Business Practice Location Address
First Line	:	1609 CUMMINS PARKWAY
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50311-0000
Country	:	US
Telephone Number	:	515-246-1840
Fax Number	:	515-246-8236

Authorized Official
Title or Position	:	SENIOR VP & CHIEF FINANCIAL OFFICER
Name	:	SCOTT HOFFMAN
Credential	:
Telephone Number	:	402-896-3884

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	01/22/2024

Similar Medicare Providers

1174675011 — MOSAIC
Practice Location Address:

1231 40TH STREET
DES MOINES, IA
50311-0000

Practice Phone: 515-246-1840
Practice Fax: 515-246-8236

1235281171 — MOSAIC
Practice Location Address:

5417 SW 14TH STREET
DES MOINES, IA
50315-0000

Practice Phone: 515-246-1840
Practice Fax: 515-246-8236

1144372087 — MOSAIC
Practice Location Address:

404 SW ROSE
DES MOINES, IA
50315-0000

Practice Phone: 515-246-1840
Practice Fax: 515-246-8236

1962554808 — MOSAIC
Practice Location Address:

4216 EASTON BLVD
DES MOINES, IA
50317-0000

Practice Phone: 515-246-1840
Practice Fax: 515-246-8236

1245382183 — MOSAIC
Practice Location Address:

1429 SW PAYTON
DES MOINES, IA
50315-0000

Practice Phone: 515-246-1840
Practice Fax: 515-246-8236

1154473098 — MOSAIC
Practice Location Address:

3849 SHERMAN BLVD
DES MOINES, IA
50310-0000

Practice Phone: 515-246-1840
Practice Fax: 515-246-8236

Directions to “MOSAIC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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