Imani Community Center

LBN: Imani Community Center
Imani Community Center is an health care organization with primary practice located at 207 Poplar St , Kosciusko MS 39339. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Managed Care Organizations / Preferred Provider Organization. Behavioral Health & Social Service Providers / Mental Health is the primary health care specialty. Imani Community Center can be contacted via phone (662) 803-1254, or through Ndiaye, Allie G via phone (662) 803-1254.

Contact Information

Primary practice address
207 Poplar St Kosciusko MS 39339
Phone: (662) 803-1254
Fax: (662) 289-1010
Website:
Map and Directions
Authorized official contact:
Name: Ndiaye, Allie G ETC.
Phone: (662) 803-1254

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0050750 Mississippi
Managed Care Organizations / Preferred Provider Organization 305R00000X 08533763 Mississippi

Profile Details

NPI number 1740650969
LBN Legal business name Imani Community Center
DBA Doing business as
Authorized official Ndiaye, Allie G ETC.
Entity Organization
Organization subpart 1 No
Enumeration date Sep 30th, 2015
Last updated Sep 30th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1740650969 NPPES
Mississippi MEDICAID 1457623118
Mississippi MEDICAID 1275977357
Mississippi MEDICAID 1245502962

Popular Providers