Provider Demographics
NPI:1568176220
Name:MOSAIC THERAPEUTIC SERVICES LTD.
Entity Type:Organization
Organization Name:MOSAIC THERAPEUTIC SERVICES LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBEROI
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:612-616-0204
Mailing Address - Street 1:8845 HIDDEN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55344-4105
Mailing Address - Country:US
Mailing Address - Phone:612-612-9189
Mailing Address - Fax:
Practice Address - Street 1:8845 HIDDEN OAKS DR
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55344-4105
Practice Address - Country:US
Practice Address - Phone:612-612-9189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)