MEDICARE: MOSAIC COMMUNITY SERVICES, INC.

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	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)	MH-2045	MD

General Provider Information

NPI Number	:	1427502046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSAIC COMMUNITY SERVICES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 45709
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21297-5709
Country	:	US
Telephone Number	:	410-453-9553
Fax Number	:	443-659-2429

Provider Business Practice Location Address
First Line	:	9201 PHILADELPHIA RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21237-4318
Country	:	US
Telephone Number	:	410-574-7700
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR, REVENUE CYCLE
Name	:	SUE KESSLER
Credential	:
Telephone Number	:	410-382-8111

Provider Enumeration Date	:	08/11/2016
Last Update Date	:	05/13/2026

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