| Organization Name: | MOSAIC UNLIMITED INC |
| NPI Number: | 1124379755 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RENEE KELLER (DIRECTOR) |
| Mailing Address: | 9 Junction Dr W Suite 2 Glen Carbon |
| State: | IL US |
| Postal Code: | 620342931 |
| Phone Number: | 6184070900 |
| Fax Number: | 6182053275 |
| NPI Enumeration Date: | 09/22/2012 |
| NPI Last Update Date: | 09/22/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 149015007 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |