NPI 1053468553

Mosaic

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Pontiac, IL

Practice location

Address: 110 W Water St STE 2, Pontiac, IL 61764-1949
Phone: (815) 842-4166
Fax: (815) 842-4053
Mailing address: 4980 S 118th St, Omaha, NE 68137-2200

Authorised official

Name: Scott Hoffman
Title: Svp/Chief Financial Officer
Phone: (402) 896-3884

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Illinois →

Registry record

NPI: 1053468553
Entity type: Organization
NPI issued: 5 Jan 2007
Record last updated: 28 Sep 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.