Organization
IMANI WOUNDCARE SERVICES INC
Active
Parent organization
IMANI WOUNDCARE SERVICES INC
Other names
WC Home Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
IMANI WOUNDCARE SERVICES INC
Authorized official
EMMA JACKSON NP (MANAGER)
(909) 614-3039
Entity
Organization
Contact information
Practice address
27555 YNEZ RD STE 210, TEMECULA, CA 92591-4678
(909) 614-3039
Mailing address
27555 YNEZ RD STE 210, TEMECULA, CA 92591-4678
(909) 614-3039
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
334700186
HCO NUMBER
CA
Enumeration date
08/30/2022
Last updated
08/02/2023
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