NPI 1295174555

Imani Community Out Reach Center

Organisation Preferred Provider Organization Kosciusko, MS

Practice location

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

Authorised official

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

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 7862 (MS)

Other Preferred Provider Organization providers in Mississippi →

Registry record

NPI: 1295174555
Entity type: Organization
NPI issued: 20 Jun 2013
Record last updated: 20 Jun 2013

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.