NPIMap

Organization Active NPI

Imani Community Outreach Center

  • Private Vehicle
  • Kosciusko, MS
National Provider Identifier
1154765808
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Private VehicleTaxonomy code 347C00000X
Legal business name
IMANI COMMUNITY OUTREACH CENTER
Practice address
301 E Jefferson St
Kosciusko, MS 39090
Phone
(662) 289-7676
NPI assigned
Apr 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Allie Glee Ndiaye I, LPN
Title
Ceo
Phone
(662) 289-7676

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 45383910 MS
Private Vehicle 347C00000X MS Primary
Respite Care 385H00000X MS

Addresses

Primary practice location

301 E Jefferson St
Kosciusko, MS 39090

Mailing address

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

Other names 1

  • Imani Community OutReach Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Imani Community Outreach Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1154765808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 E JEFFERSON ST",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903719",
            "telephone_number": "662-289-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 E JEFFERSON ST",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "39090",
            "telephone_number": "662-289-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMANI COMMUNITY OUTREACH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NDIAYE",
        "authorized_official_first_name": "ALLIE",
        "authorized_official_middle_name": "GLEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-289-7676",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "LPN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MS",
            "license": "45383910",
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "MS",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MS",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Imani Community OutReach Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Kosciusko, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.