IMANI COMMUNITY OUTREACH CTR INC NPI 1912264250

NPI Details

IMANI COMMUNITY OUTREACH CTR INC is a home health in Kosciusko, MS. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. IMANI COMMUNITY OUTREACH CTR INC NPI is 1912264250. The provider is registered as an organization entity type.

The provider's business location address is:

301 E JEFFERSON ST
KOSCIUSKO, MS
ZIP 39090-719
Phone: (662) 289-7676
Fax: (662) 289-7678

The provider's authorized official is Tricia Duncan .
The authorized official title is Biller and has the following contact phone number (601) 878-6945.

The enumeration date for this NPI number is 4/11/2012 and was last updated on 4/11/2012.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.