MOSAIC (NPI# 1053468553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053468553 |
| Entity Type | Organization |
| Organization Name | MOSAIC |
| Practice Address |
110 W Water St Ste 2 Pontiac IL 61764-1949 |
| Mailing Address |
4980 S 118th St Omaha NE 68137-2220 |
| Practice Telephone | 8158424166 |
| Practice Fax Number | 8158424053 |
| Mailing Telephone | 4028963884 |
| Mailing Fax Number | 4028944780 |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2020-11-05 |
| Authorized Official Name | JERI SOLE (DIRECTOR OF BILLING) |
| Authorized Official Telephone | 4028965827 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | ========= | IL | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487920351 | Mosaic | Intermediate Care Facility, Mentally Retarded | 835 S 7th St, Forest City, IA 50436-2127 | 2012-03-26 |
| 1306112271 | Mosaic | Intermediate Care Facility, Mentally Retarded | 102 Kellys Ct, Forest City, IA 50436-2245 | 2012-03-26 |
| 1710253687 | Mosaic | Intermediate Care Facility, Mentally Retarded | 105 Kellys Ct, Forest City, IA 50436-2245 | 2012-03-26 |
| 1831465715 | Mosaic | Intermediate Care Facility, Mentally Retarded | 315 Country Club Dr, Belmond, IA 50421-1740 | 2012-03-26 |
| 1851666820 | Mosaic | Intermediate Care Facility, Mentally Retarded | 718 S 13th St, Nevada, IA 50201-2435 | 2012-03-09 |
| 1487952297 | Mosaic | Intermediate Care Facility, Mentally Retarded | 2000 W Park Ave, Norfolk, NE 68701-4701 | 2011-03-02 |
| 1790003614 | Mosaic | Intermediate Care Facility, Mentally Retarded | 1517 Hope St, Grand Island, NE 68801-7101 | 2010-05-17 |
| 1073831996 | Mosaic | Intermediate Care Facility, Mentally Retarded | 2814 S 169 St, Omaha, NE 68116 | 2010-05-17 |
| 1982922803 | Mosaic | Intermediate Care Facility, Mentally Retarded | 5806 S 147th St, Omaha, NE 68137-2538 | 2010-05-17 |
| 1609194521 | Mosaic | Intermediate Care Facility, Mentally Retarded | 1433 Grandview Ave, Papillion, NE 68046-5754 | 2010-05-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MOSAIC | 4980 S 118th St, Omaha, NE 68137-2200 |
| Washington State Corporations | MOSAIC | 1571 Hemlock Dr, Oak Harbor, WA 98277 |
| Colorado Business Entities | MOSAIC | 17020 E. 104th Place, Commerce City, CO 80022 |
| Oregon Corporations, Companies and Business Names | MOSAIC | 662 W 25th Pl, Eugene, OR 97405 |
| Oklahoma Business Registrations | MOSAIC | 4980 S 118th St, Omaha, NE 68137 |
| Indiana Business Entities | MOSAIC | 4980 S. 118th Street, Omaha, NE 68137-2220 |
| Oregon Corporations, Companies and Business Names | MOSAIC & TILE INSTALLATION | 4485 Great Plains Dr Ne, Salem, OR 97305 |
| New York State Corporations | MOSAIC 227 ENTERPRISES, LLC | Clifford H Greene & Associates, 467 North Avenue, New Rochelle, Ny 10801 |
| Oregon Corporations, Companies and Business Names | MOSAIC 331 | 331 Main Street, Springfield, OR 97477 |
| Oklahoma Business Registrations | MOSAIC 516, LLC | 2320 Overholser Ct, Oklahoma City, OK 73127 |
| Street Address |
110 W WATER ST STE 2 |
| City | PONTIAC |
| State | IL |
| Zip Code | 61764-1949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497165211 | Barbara Kay Browning | Counselor | 310 E. Torrance Ave, Pontiac, IL 61764 | 2014-05-01 |
| 1407287121 | Institute for Human Resources of Livingston County, Il | Community/Behavioral Health | 301 E Torrance Ave, Pontiac, IL 61764 | 2013-12-05 |
| 1982031241 | Annette G Franzen | Psychologist | 700 W Lincoln St # 406, Pontiac, IL 61764 | 2013-10-02 |
| 1871739185 | Woodridge of Ponitac LLC | Assisted Living Facility | 120 North Deerfield Road, Pontiac, IL 61764 | 2008-12-17 |
| 1861601171 | William Earl Hammond | Chiropractor | 210b Ladd, Pontiac, IL 61764 | 2007-05-22 |
| 1932259983 | Amy Duffy | Counselor | 210 W Water St Ste 1, Pontiac, IL 61764 | 2007-01-11 |
| 1326123340 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1034 W. Reynolds Street, Pontiac, IL 61764 | 2006-10-26 |
| 1205932977 | Gary Merl Leverton | Dentist | 518 West Madison St, Pontiac, IL 61764 | 2006-09-16 |
| 1891899886 | Robert E Heins | Family Medicine | 520 West Madison, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| 1710081708 | Kenneth N Jordan | Family Medicine | 520 West Madison Street, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| Find all providers in zip 61764 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275131419 | Foatex Health Cilacare | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 823 163rd St, Calumet City, IL 60409-5915 | 2020-10-10 |
| 1053949404 | A Great Place To Stay LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 35580 N Knowles Rd, Lake Villa, IL 60046-9026 | 2020-03-31 |
| 1255966602 | Infinicare LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1939 Waukegan Rd Ste 300, Glenview, IL 60025-1758 | 2020-03-05 |
| 1023643772 | Supporting Community Independence | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1 Polo Grounds Ct, Bethalto, IL 62010-2623 | 2020-03-03 |
| 1770116287 | Universal Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12101 S La Salle St, Chicago, IL 60628-6618 | 2020-02-13 |
| 1760014625 | Tomeka R Morgan | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11543 S Ashland Ave, Chicago, IL 60643-5001 | 2020-02-10 |
| 1487292660 | Shalom Home Health Ltd | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8147 Seminole Ct, Orland Park, IL 60462-4919 | 2019-12-18 |
| 1447894613 | Compassionate Living Home Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2625 Butterfield Rd Ste 314e, Oak Brook, IL 60523-1234 | 2019-10-31 |
| 1417599945 | Miracle Comprehensive Serivces | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4440 Lincoln Hwy Ste 205, Matteson, IL 60443-3803 | 2019-10-16 |
| 1609435072 | Bliss Haven, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1304 Durham St, Johnston City, IL 62951-2043 | 2019-06-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.