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Organization

IMANI HOUSE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SAKINAH MUJAHID (DIRECTOR OF PROGRAM DEVEOLPMENT)
(850) 459-4956
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary

Other

Enumeration date
03/30/2012
Last updated
03/30/2012
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