MOSAIC OF THE SOUTHWEST NPI 1720295843

NPI Information

NPI: 1720295843
Provider Name: MOSAIC OF THE SOUTHWEST
Classification: Intermediate Care Facility, Intellectual Disabilities - 315P00000X
Entity Type: Organization
Address:
775 COLUMBIA AVE
MERCED, CA
ZIP 95340
Phone: (559) 451-0399
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MOSAIC OF THE SOUTHWEST is an intermediate care facility mentally retarded in Merced, CA. The provider is an intermediate care facility providing services for individuals with intellectual disabilities. MOSAIC OF THE SOUTHWEST NPI is 1720295843. The provider is registered as an organization entity type.

The provider's business location address is:

775 COLUMBIA AVE
MERCED, CA
ZIP 95340-920
Phone: (559) 451-0399

The provider's authorized official is Sally Montgomery .
The authorized official title is Vice President and has the following contact phone number (402) 896-3884.

The enumeration date for this NPI number is 5/17/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	315P00000X	Intermediate Care Facility, Intellectual Disabilities			CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LTC80310F	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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