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

General Provider Information

NPI Number	:	1952676926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOSAIC

Provider Business Mailing Address
First Line	:	102 W PARK ST
Second Line	:
City	:	FOREST CITY
State	:	IA
Zip	:	50436-2132
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 1ST ST SE
Second Line	:
City	:	CLARION
State	:	IA
Zip	:	50525-2086
Country	:	US
Telephone Number	:	641-585-5451
Fax Number	:

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

Provider Enumeration Date	:	03/09/2012
Last Update Date	:	06/08/2021

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Directions to “MOSAIC ” Practice Location

Language	Start Address	Practice Location

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