| Mosaic Behavioral Health, Llc | |
|
5026 Tennyson Pkwy Plano TX 75024-3360 | |
| (469) 361-0467 | |
| Not Available |
| Full Name | Mosaic Behavioral Health, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5026 Tennyson Pkwy, Plano, Texas |
| Authorized Official Name and Position | Jay Italiya (DIRECTOR) |
| Authorized Official Contact | 4693610467 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Behavioral Health, Llc 2840 Legacy Dr Ste 400 Frisco TX 75034-6055 Ph: () - | Mosaic Behavioral Health, Llc 5026 Tennyson Pkwy Plano TX 75024-3360 Ph: (469) 361-0467 |
| NPI Number | 1720788755 |
|---|---|
| Provider Enumeration Date | 03/08/2023 |
| Last Update Date | 01/23/2024 |
| Certification Date | 11/28/2023 |
| Medicare PECOS PAC ID | 3678921269 |
|---|---|
| Medicare Enrollment ID | O20231120002743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720788755 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Jay Italiya |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194221606 PECOS PAC ID: 9537517131 Enrollment ID: I20231120002969 |
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