NPI 1134513765
Mosaic Community Services, LLC
Practice location
- Address
- 602 Matthews Ave, Sikeston, MO 63801-3259
- Phone
- (573) 621-5160
- Fax
- (573) 621-5161
- Mailing address
- 602 Matthews Ave P.O. Box 1522, Sikeston, MO 63801-3259
Authorised official
- Name
- Benjamin Park Hartzog
- Title
- Executive Director
- Phone
- (573) 225-7614
Registered specialties
In Home Supportive Care Agency
Primary
Registry record
- NPI
- 1134513765
- Entity type
- Organization
- NPI issued
- 20 Mar 2015
- Record last updated
- 2 Apr 2015
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.