Provider Demographics
NPI:1114207214
Name:MOSAIC MUSIC THERAPY & NEURO-REHABILITATION, LLC
Entity Type:Organization
Organization Name:MOSAIC MUSIC THERAPY & NEURO-REHABILITATION, LLC
Other - Org Name:MOSAIC MUSIC INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEICK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, MMH, MT-BC, CBIS
Authorized Official - Phone:732-859-7038
Mailing Address - Street 1:1933 HIGHWAY 35
Mailing Address - Street 2:SUITE 105-282
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-3502
Mailing Address - Country:US
Mailing Address - Phone:732-859-7038
Mailing Address - Fax:
Practice Address - Street 1:1707 ATLANTIC AVE
Practice Address - Street 2:BUILDING 2, SUITE 2
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1147
Practice Address - Country:US
Practice Address - Phone:732-859-7038
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-19
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Multi-Specialty
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty