| Organization Name: | MOSAIC COMMUNITY SERVICES |
| NPI Number: | 1528229283 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFF RICHARDSON (CHIEF EXECUTIVE OFFICER) |
| Mailing Address: | 40 S Dundalk Ave Dundalk |
| State: | MD US |
| Postal Code: | 212224267 |
| Phone Number: | 4102858157 |
| Fax Number: | 4102858298 |
| NPI Enumeration Date: | 06/24/2008 |
| NPI Last Update Date: | 04/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | 100406 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |