NPI 1154765808

Imani Community Outreach Center

Organisation Private Vehicle Kosciusko, MS

Practice location

Address: 301 E Jefferson St, Kosciusko, MS 39090
Phone: (662) 289-7676
Mailing address: 301 E Jefferson St, Kosciusko, MS 39090-3719

Authorised official

Name: Allie Glee Ndiaye
Title: Ceo
Phone: (662) 289-7676

Registered specialties (3)

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X

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Adult Care Home Facility

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X Licence 45383910 (MS)

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Respite Care

Respite Care Facility Taxonomy 385H00000X

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Registry record

NPI: 1154765808
Entity type: Organization
NPI issued: 24 Apr 2013
Record last updated: 21 Jul 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.