Provider Demographics
NPI:1417103649
Name:MOSAIC FAMILY COUNSELING CENTER, INC.
Entity type:Organization
Organization Name:MOSAIC FAMILY COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KENYA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-771-3672
Mailing Address - Street 1:3705 GRAND AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-2805
Mailing Address - Country:US
Mailing Address - Phone:515-724-8920
Mailing Address - Fax:888-771-3225
Practice Address - Street 1:6200 AURORA AVE STE 305E
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-2863
Practice Address - Country:US
Practice Address - Phone:515-724-8920
Practice Address - Fax:712-545-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-07
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty