NPI 1174663801

Mosaic

Organisation Mental Illness Community Based Residential Treatment Facility Logan, IA

Practice location

Address: 217 E 7th St, Logan, IA 51546-1348
Phone: (712) 644-2378
Fax: (712) 664-3501
Mailing address: 4980 S 118th St, Omaha, NE 68137-2220

Authorised official

Name: Dean Wilson
Title: Vp Accounting
Phone: (402) 896-3884

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 2439232 (IA)

Other Community Based Residential Treatment Facility, Mental Illness providers in Iowa →

Registry record

NPI: 1174663801
Entity type: Organization
NPI issued: 8 Feb 2007
Record last updated: 22 Aug 2020

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.