# IMANI HOUSE

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

## Provider details

- **NPI number:** 1710253091
- **Authorized official:** MS. SAKINAH MUJAHID (DIRECTOR OF PROGRAM DEVEOLPMENT)
- **Authorized official phone:** (850) 459-4956

## Contact information

- **Practice address:** 709 MILLARD ST, TALLAHASSEE, FL 32301-7037
- **Practice address phone:** (850) 878-8870
- **Practice address fax:** (850) 877-1760
- **Mailing address:** 709 MILLARD ST, TALLAHASSEE, FL 32301-7037
- **Mailing address phone:** (850) 878-8870
- **Mailing address fax:** (850) 877-1760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/30/2012
- **Last updated:** 03/30/2012