IMANI COMMUNITY OUTREACH CENTER (NPI# 1245502962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245502962 |
| Entity Type | Organization |
| Organization Name | IMANI COMMUNITY OUTREACH CENTER |
| Practice Address |
301 E Jefferson St Kosciusko MS 39090-3719 |
| Practice Telephone | 6622897676 |
| Mailing Telephone | 6622897676 |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-03-12 |
| Authorized Official Name | TRICIA B DUNCAN (BILLER) |
| Authorized Official Telephone | 6018786945 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 376J00000X | Homemaker | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 09950749 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467726000 | Imani Community Outreach Center | Nursing Care | 308 N Jackson Street, Kosciusko, MS 39090-1453 | 2012-02-29 |
| 1457623118 | Imani Community Outreach Center | Respite Care | 207 Poplar St, Kosciusko, MS 39090-4409 | 2012-01-27 |
| 1154765808 | Imani Community Outreach Center | Custodial Care Facility | 301 E Jefferson St, Kosciusko, MS 39090 | 2013-04-24 |
| 1912273624 | Imani Community Outreach Center | Physical Therapist | 301 E Jefferson St, Kosciusko, MS 39090-3719 | 2012-03-27 |
| 1477829182 | Imani Community Outreach Center | Occupational Therapist | 301 E Jefferson St, Kosciusko, MS 39090-3719 | 2012-03-27 |
| 1467728360 | Imani Community Outreach Center | Social Worker | 301 E Jefferson St, Kosciusko, MS 39090-3719 | 2012-03-26 |
| Street Address |
301 E JEFFERSON ST |
| City | KOSCIUSKO |
| State | MS |
| Zip Code | 39090-3719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295174555 | Imani Community Out Reach Center | Preferred Provider Organization | 301 E Jefferson St, Kosciusko, MS 39090-3719 | 2013-06-20 |
| 1154765808 | Imani Community Outreach Center | Custodial Care Facility | 301 E Jefferson St, Kosciusko, MS 39090 | 2013-04-24 |
| 1912264250 | Imani Community Outreach Ctr Inc | Home Health | 301 E Jefferson St, Kosciusko, MS 39090-3719 | 2012-04-11 |
| 1912273624 | Imani Community Outreach Center | Physical Therapist | 301 E Jefferson St, Kosciusko, MS 39090-3719 | 2012-03-27 |
| 1477829182 | Imani Community Outreach Center | Occupational Therapist | 301 E Jefferson St, Kosciusko, MS 39090-3719 | 2012-03-27 |
| 1467728360 | Imani Community Outreach Center | Social Worker | 301 E Jefferson St, Kosciusko, MS 39090-3719 | 2012-03-26 |
| 1669749081 | Imani Community Outreach Ctr | Driver | 301 E Jefferson St, Kosciusko, MS 39090-3719 | 2011-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508371675 | Caroline Boydstun Fair | Pharmacist | 109 Northside Center, Kosciusko, MS 39090 | 2017-12-11 |
| 1275069643 | Sharhonda Wingo | Speech-Language Pathologist | 2447 Attala Road 2203, Kosciusko, MS 39090 | 2017-05-04 |
| 1013392034 | Leap of Faith LLC | Respite Care | 115 North Wells Street, Suite A, Kosciusko, MS 39090 | 2015-07-21 |
| 1730566027 | Bmc - Attala, LLC | General Acute Care Hospital | 220 Hwy. 12 West, Kosciusko, MS 39090 | 2015-05-06 |
| 1528402484 | Warner Martin Myers I | Student in an Organized Health Care Education/Training Program | 912 Hwy 12 East, Kosciusko, MS 39090 | 2013-04-23 |
| 1891022547 | Medical Foundation of Central Mississippi | Internal Medicine | 329 Highway 12 West, Koscuisko, MS 39090 | 2009-11-17 |
| 1255512448 | Cheryl L Bayne | Adult Companion | 509 Hillview Dr, Kosciusko, MS 39090 | 2007-11-16 |
| 1760673982 | Gary A Cochran | Technician/Technologist | 118 West North St, Kosciusko, MS 39090 | 2007-08-05 |
| 1639396393 | Stephen C Hammack | Family Medicine | 332 Highway 12 West, Kosciusko, MS 39090 | 2007-04-20 |
| 1740329689 | Brenda Nail | Nurse Practitioner | 999 Martin Luther King Drive, Kosciusko, MS 39090 | 2007-02-06 |
| Find all providers in zip 39090 | ||||
| Taxonomy Code | 376J00000X |
| Grouping | Nursing Service Related Providers |
| Classification | Homemaker |
| An individual who provides general household activities such as meal preparation, laundry, and light housekeeping, when the individual regularly responsible for these activities is temporarily absent or unable to provide for himself. Homemakers must meet the state defined training standards. |
| Notes: [7/1/2003: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265951834 | Trucare Nursing Service LLC | Homemaker | 2899 Attala Road 3022, Kosciusko, MS 39090-5038 | 2017-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063011682 | Tiffany Denice Redd | Homemaker | 15092 S Jackson St, Durant, MS 39063-3900 | 2020-10-23 |
| 1952924763 | Southern Touch Homemaker & Comfort Agency LLC | Homemaker | 501a Lumberton Rd, Columbia, MS 39429-3515 | 2020-05-27 |
| 1831710714 | Annette Santiago | Homemaker | 2019 Springwood Rd, Gautier, MS 39553-7301 | 2020-05-01 |
| 1548895261 | More Than Help Healthcare Services LLC | Homemaker | 124 Carriage Ln, Florence, MS 39073-6015 | 2020-03-04 |
| 1467083907 | Ratoya Walker | Homemaker | 34 Jims Rd, Columbia, MS 39429-8265 | 2020-02-03 |
| 1982249702 | Patricia A Holloway | Homemaker | 115 S Pearl St, Carthage, MS 39051-4131 | 2019-11-15 |
| 1124662531 | Dorothy M Moore | Homemaker | 2211 Highway 45 N Ste G2211, Meridian, MS 39301-2730 | 2019-10-30 |
| 1912548181 | Tammy S Ramsey | Homemaker | 4653 Highway 15 N, Laurel, MS 39443-9473 | 2019-09-30 |
| 1780232801 | Kimberly Thompson | Homemaker | 230 Sawyer Rd, Winona, MS 38967-9504 | 2019-09-02 |
| 1376103408 | Deneitra Jones | Homemaker | 131 Bainbridge Xing, Canton, MS 39046-6031 | 2019-06-20 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.