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MOSAIC

Intermediate Care Facility, Mentally Retarded

Axtell, Nebraska

Provider NPI: 1972706885

Organization Information:
Organization Name:  MOSAIC


Practice Location:
1044 23RD RD  AXTELL, NE 68924 US
Tel: 308-743-2401  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
NEICFMR02

Other Provider Identifiers:

IssuerNumberStateType
PROVIDER NUMBER10025284000NE01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS NE - Page 1



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