Imani Community Outreach Ctr

LBN: Imani Community Outreach Ctr
Imani Community Outreach Ctr is an health care organization with primary practice located at 301 E Jefferson St , Kosciusko MS 39090-3719. The organization recently has only one registered license in Other Service Providers / Driver, which is considered as the primary health care specialty. Imani Community Outreach Ctr can be contacted via phone (662) 289-7676, or through Duncan, Tricia B via phone (601) 878-6945.

Contact Information

Primary practice address
301 E Jefferson St Kosciusko MS 39090-3719
Phone: (662) 289-7676
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Duncan, Tricia B
Phone: (601) 878-6945

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X

Profile Details

NPI number 1669749081
LBN Legal business name Imani Community Outreach Ctr
DBA Doing business as
Authorized official Duncan, Tricia B
Entity Organization
Organization subpart 1 No
Enumeration date Nov 30th, 2011
Last updated Mar 12th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669749081 NPPES
Mississippi MEDICAID 00686258

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