Mosaic Medical Ensworth School Based Health Center

LBN: Mosaic Medical
Mosaic Medical Ensworth School Based Health Center is an health care organization with primary practice located at 2150 Ne Daggett Ln , Bend OR 97701-6560. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Mosaic Medical can be contacted via phone (541) 323-3850, or through Haase, Megan via phone (541) 447-0707.

Contact Information

Primary practice address
2150 Ne Daggett Ln Bend OR 97701-6560
Phone: (541) 323-3850
Fax: (541) 383-1883
Website:
Map and Directions
Authorized official contact:
Name: Haase, Megan Nurse Practitioner (NP)
Phone: (541) 447-0707

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X

Profile Details

NPI number 1649681560
LBN Legal business name Mosaic Medical
DBA Doing business as Mosaic Medical Ensworth School Based Health Center
Authorized official Haase, Megan Nurse Practitioner (NP)
Entity Organization
Organization subpart 1 Yes
Enumeration date May 13th, 2014
Last updated Apr 19th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649681560 NPPES
Oregon MEDICAID 182960

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