Organization
IMANI'S VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FARAH MAYBERRY (PRESIDENT)
(405) 473-5745
Entity
Organization
Contact information
Practice address
1745 NW 16TH ST STE A, OKLAHOMA CITY, OK 73106-2078
(405) 473-5745
Mailing address
4828 NW 65TH ST, OKLAHOMA CITY, OK 73132-6829
Taxonomy
Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
Primary
—
—
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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