IMANI HOUSE MEDICAL SERVICES NPI 1184233595

NPI Information

NPI: 1184233595
Provider Name: IMANI HOUSE MEDICAL SERVICES
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Organization

Specialization: Psychiatric/Mental Health

CLIA Number: 21D2107453

Address:
6101 PARK HEIGHTS AVE APT 1D
BALTIMORE, MD
ZIP 21215
Phone: (410) 624-7190
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IMANI HOUSE MEDICAL SERVICES is a psychiatric/mental health nurse practitioner in Baltimore, MD. IMANI HOUSE MEDICAL SERVICES NPI is 1184233595. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6101 PARK HEIGHTS AVE APT 1D
BALTIMORE, MD
ZIP 21215-640
Phone: (410) 624-7190
Fax: (410) 624-7193

The provider's authorized official is Annette Youvonne Kingel .
The authorized official title is Nurse Practitioner and has the following contact phone number (410) 624-7190.

The CLIA number assigned to this NPI record is 21D2107453 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/31/2020 and was last updated on 7/31/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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