Provider Demographics
NPI:1144069857
Name:MOSAIC HEALTH COLLECTIVE INC
Entity type:Organization
Organization Name:MOSAIC HEALTH COLLECTIVE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RING
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-407-1923
Mailing Address - Street 1:12 WINCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-2912
Mailing Address - Country:US
Mailing Address - Phone:978-407-1923
Mailing Address - Fax:
Practice Address - Street 1:12 WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-2912
Practice Address - Country:US
Practice Address - Phone:978-407-1923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty