IMANI COMMUNITY OUT REACH CENTER (NPI# 1295174555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295174555 |
| Entity Type | Organization |
| Organization Name | IMANI COMMUNITY OUT REACH CENTER |
| Other Organization Name | GARDEN ANGLES |
| Practice Address |
301 E Jefferson St Kosciusko MS 39090-3719 |
| Practice Telephone | 6622897676 |
| Mailing Telephone | 6622897676 |
| Enumeration Date | 2013-06-20 |
| Last Update Date | 2013-06-20 |
| Authorized Official Name | MS. ALLIE G NDIAYE I (CEO) |
| Authorized Official Telephone | 6622897676 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | 7862 | MS | Managed Care Organizations |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | CLINIC SOCIAL WORKER | 172V00000X | 01 |
| MS | HOSPICE | 08533763 | 01 |
| ADULT DAY CARE | 261QA0600X | 01 |
| Other Name | Type Code |
|---|---|
| Garden Angles | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275977357 | Imani Community Out Reach Center | Clinic/Center | 308 N Jackson St, Kosciusko, MS 39090-3322 | 2013-04-19 |
| Street Address |
301 E JEFFERSON ST |
| City | KOSCIUSKO |
| State | MS |
| Zip Code | 39090-3719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1245502962 | Imani Community Outreach Center | Homemaker | 301 E Jefferson St, Kosciusko, MS 39090-3719 | 2012-01-27 |
| 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 | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740650969 | Imani Community Center | Preferred Provider Organization | 207 Poplar St, Kosciusko, MS 39339 | 2015-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033609581 | Reconnect Wellnes Pascagoula LLC | Preferred Provider Organization | 4211 Hospital St Ste 114, Pascagoula, MS 39581-5320 | 2018-05-10 |
| 1912436981 | Reconnect Wellness Winona LLC | Preferred Provider Organization | 100 N Front St Ste A, Winona, MS 38967-2220 | 2017-06-05 |
| 1396286456 | Reconnect Wellness Bruce LLC | Preferred Provider Organization | 131 Public Square, Bruce, MS 38915 | 2017-03-09 |
| 1932648367 | Reconnect Wellness Laurel, LLC | Preferred Provider Organization | 910 Sawmill Rd Ste D29, Laurel, MS 39440-3961 | 2017-02-17 |
| 1598219511 | Love and Patience | Preferred Provider Organization | 14199 Ballentine Rd, Sardis, MS 38666-5416 | 2016-08-08 |
| 1790158293 | Jbchiro1 LLC | Preferred Provider Organization | 11516 Lamey Bridge Rd, Suite E, Diberville, MS 39540-2725 | 2015-11-05 |
| 1750725297 | New Covenant Daycare | Preferred Provider Organization | 960 Highway 4 E, Holly Springs, MS 38635-2145 | 2013-04-27 |
| 1033454459 | Precious Hands Personal Care LLC | Preferred Provider Organization | 169 Rankin Rd, Columbia, MS 39429-3715 | 2012-12-11 |
| 1558613505 | Doddsville Adult Day Care | Preferred Provider Organization | 133 Miller, Doddsville, MS 38736-8736 | 2012-10-15 |
| 1184941676 | Oncall Medical Clinic, Pllc | Preferred Provider Organization | 3091 Bienville Blvd, Ocean Springs, MS 39564-4308 | 2010-04-23 |
| 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.