Provider Demographics
NPI:1649895426
Name:MOSAICS PUBLIC SCHOOL INC.
Entity type:Organization
Organization Name:MOSAICS PUBLIC SCHOOL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:HASKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-402-8899
Mailing Address - Street 1:1010 W JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5445
Mailing Address - Country:US
Mailing Address - Phone:208-402-8899
Mailing Address - Fax:208-606-3527
Practice Address - Street 1:3121 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-8171
Practice Address - Country:US
Practice Address - Phone:208-402-8899
Practice Address - Fax:208-606-3527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)