# IMANI HOUSE MEDICAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184233595
- **Authorized official:** ANNETTE YOUVONNE KINGEL DR. (NURSE PRACTITIONER)
- **Authorized official phone:** (410) 624-7190

## Contact information

- **Practice address:** 6101 PARK HEIGHTS AVE APT 1D, BALTIMORE, MD 21215-3640
- **Practice address phone:** (410) 624-7190
- **Practice address fax:** (410) 624-7193
- **Mailing address:** 6101 PARK HEIGHTS AVE APT 1D, BALTIMORE, MD 21215-3640
- **Mailing address phone:** (410) 624-7190
- **Mailing address fax:** (410) 624-7193

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/31/2020
- **Last updated:** 07/31/2020