MOSAIC (NPI# 1972706885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972706885 |
| Entity Type | Organization |
| Organization Name | MOSAIC |
| Practice Address |
1044 23rd Rd Axtell NE 68924-3679 |
| Mailing Address |
4980 S 118th St Omaha NE 68137-2220 |
| Practice Telephone | 3087432401 |
| Practice Fax Number | 3087432659 |
| Mailing Telephone | 4028963884 |
| Mailing Fax Number | 4028944780 |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2020-11-09 |
| 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 | 315P00000X | Intermediate Care Facility, Mentally Retarded | ICFMR02 | NE | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | PROVIDER NUMBER | 10025284000 | 01 |
| 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 |
| Washington State Corporations | MOSAIC 3RD SECTOR CONSULTING, LLC | 1203 S 223rd St, Des Moines, WA 98198-4529 |
| Street Address |
1044 23RD RD |
| City | AXTELL |
| State | NE |
| Zip Code | 68924-3679 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031985 | Rebecca Violet Hubbard | Registered Nurse | 506 A Ave, Axtell, NE 68924-3414 | 2020-07-28 |
| 1346753696 | Lucas J Houchin | Behavioral Analyst | 203 E 5th St, Axtell, NE 68924-3418 | 2017-11-08 |
| 1629155403 | Axtell Rural Fire Department No 4 | Ambulance | 202 E 6th St, Axtell, NE 68924-3419 | 2006-11-01 |
| 1932714813 | Mosiac | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1044 23 Rd, Axtell, NE 68924-3679 | 2020-09-09 |
| 1073961785 | Jennifer Marshall | Speech-Language Pathologist | 1 Pheasant Run, Axtell, NE 68924-3680 | 2016-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023586 | Melanie Nicole Butcher | Registered Nurse | 617 Cavin Ln, Axtell, TX 76624-1280 | 2020-11-03 |
| 1164031985 | Rebecca Violet Hubbard | Registered Nurse | 506 A Ave, Axtell, NE 68924-3414 | 2020-07-28 |
| 1396384236 | Shelby Brianne Harriman | Physical Therapy Assistant | 493 Retreat Center Rd, Axtell, TX 76624-1576 | 2019-12-23 |
| 1134686124 | Stacey Deann Clark | Licensed Vocational Nurse | 1400 Barron Ln, Axtell, TX 76624-1394 | 2019-02-26 |
| 1114498060 | Amber Michelle Tindell | Registered Nurse | 285 Fuller Rd, Axtell, TX 76624-1204 | 2018-12-17 |
| 1720567639 | Rhonda Denell Moffett | Registered Nurse | 141 North 9th Street, Axtell, TX 76624 | 2018-08-10 |
| 1346753696 | Lucas J Houchin | Behavioral Analyst | 203 E 5th St, Axtell, NE 68924-3418 | 2017-11-08 |
| 1073961785 | Jennifer Marshall | Speech-Language Pathologist | 1 Pheasant Run, Axtell, NE 68924-3680 | 2016-06-03 |
| 1366873192 | Bethany Sue Perry | Speech-Language Pathologist | 606 Pine St, Axtell, KS 66403-9617 | 2013-12-04 |
| 1477842276 | Axtell Isd | Local Education Agency (LEA) | 308 Ottawa, Axtell, TX 76624-1453 | 2011-04-01 |
| Find all providers in AXTELL | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1417275546 | Mosaic | Intermediate Care Facility, Mentally Retarded | 2215 Meadow Lark Ln, York, NE 68467-1021 | 2010-05-13 |
| 1720273386 | Mosaic | Intermediate Care Facility, Mentally Retarded | 2915 W Faidley Ave, Grand Island, NE 68803-4108 | 2007-09-07 |
| 1134215700 | Phoenix Residence, Inc. | Intermediate Care Facility, Mentally Retarded | 785 E County Road E, Vadnais Heights, NE 55127 | 2006-10-04 |
| 1215383120 | Beatrice State Developmental Center | Intermediate Care Facility, Mentally Retarded | 3000 Lincoln St, Beatrice, NE 68310-3319 | 2016-05-10 |
| 1124452800 | State of Nebraska Dept. of Admin. Services | Intermediate Care Facility, Mentally Retarded | 3000 Lincoln St, Lake Street, Beatrice, NE 68310-3319 | 2013-08-29 |
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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.