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General NPI Number Information
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NPI Number | 1346515137
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Entity Type | Organization
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Legal Business Name | IMANI ENTERPRISES DBA A L NURSING HOME CARE AGENCY
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Dates
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Enumeration Date | 03/13/2012
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 1348 WEST GATE CENTER DRIVE SUITE 207
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City | WINSTON SALEM
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State | NC
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Zip | 27103-2984
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Country | US
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Telephone | 336-287-3291
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Fax | 336-499-0781
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Provider Business Mailing Address
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Address Line | 1348 WEST GATE CENTER DRIVE SUITE 207
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City | WINSTON SALEM
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State | NC
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Zip | 27103-2984
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Country | US
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Telephone | 336-287-3291
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Fax | 336-499-0781
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANNA JOHN SIMTAJI
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Credential | RN
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Telephone | 336-287-3291
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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