MOSAIC NPI 1447390992

NPI Information

NPI: 1447390992
Provider Name: MOSAIC
Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
2901 PROFESSIONAL LN
TERRE HAUTE, IN
ZIP 47802
Phone: (812) 235-3399
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MOSAIC is a community based residential treatment facility, intellectual and/or developmental disabilities in Terre Haute, IN. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. MOSAIC NPI is 1447390992. The provider is registered as an organization entity type.

The provider's business location address is:

2901 PROFESSIONAL LN
TERRE HAUTE, IN
ZIP 47802-300
Phone: (812) 235-3399
Fax: (812) 235-1590

The provider's authorized official is Scott Hoffman .
The authorized official title is Svp Chief Financial Officer and has the following contact phone number (402) 896-3884.

The enumeration date for this NPI number is 2/7/2007 and was last updated on 1/18/2024.

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			INDIANA	No
2	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities				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	100249240B	MEDICAID	INDIANA
2	100239750B	OTHER	INDIANA	E-BILLING NUMBER
3	100235510B	OTHER	INDIANA	E-BILLING NUMBER
4	100249240B	OTHER	INDIANA	E-BILLING NUMBER
5	200819770B	MEDICAID	INDIANA
6	100244480B	OTHER	INDIANA	E-BILLING NUMBER
7	200819770B	OTHER	INDIANA	PROVIDER NUMBER
8	200376380A	OTHER	INDIANA	E-BILLING NUMBER

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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