Organization
IMANI COMMUNITY OUTREACH CENTER
Active
Other names
Imami Community Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALLIE NDIAYE (CEO)
(662) 289-7676
Entity
Organization
Contact information
Practice address
308 N JACKSON STREET, KOSCIUSKO, MS 39090-1453
(662) 289-7676
(662) 289-7688
Mailing address
308 N JACKSON STREET, KOSCIUSKO, MS 39090-1453
(662) 289-7676
(662) 289-7688
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MS
Enumeration date
02/29/2012
Last updated
03/28/2014
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