| Mosaic Community Services, Inc | |
|
9201 Philadelphia Rd Baltimore MD 21237-4318 | |
| (410) 574-7700 | |
| Not Available |
| Full Name | Mosaic Community Services, Inc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 9201 Philadelphia Rd, Baltimore, Maryland |
| Authorized Official Name and Position | Jeff Richardson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4104539553 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mosaic Community Services, Inc 1925 Greenspring Dr Timonium MD 21093-4128 Ph: (410) 453-9553 | Mosaic Community Services, Inc 9201 Philadelphia Rd Baltimore MD 21237-4318 Ph: (410) 574-7700 |
| NPI Number | 1124470067 |
|---|---|
| Provider Enumeration Date | 07/03/2016 |
| Last Update Date | 07/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124470067 | NPI | - | NPPES |
| MH2043 | Other | MD | DHMH LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | MH-2043 (Maryland) | Primary |
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