Imani Community Outreach Ctr

NPI #1669749081 in Kosciusko, Mississippi

Provider Information

NPI Number: 1669749081
Entity Type: Organization
Organization Name: Imani Community Outreach Ctr
Primary Specialty: Driver
Enumeration Date: Nov 30, 2011
Last Updated: Mar 12, 2012

Practice Location

Address: 301 E JEFFERSON ST
City: Kosciusko
State: Mississippi
ZIP Code: 39090-3719
Phone: (662) 289-7676

Authorized Official

Name: TRICIA B DUNCAN
Title: BILLER
Phone: (601) 878-6945

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Driver	172A00000X	Primary

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