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General NPI Number Information
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NPI Number | 1619006640
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Entity Type | Organization
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Legal Business Name | IMANI FOUNDATION
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1074 MEMORIAL DR SE
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City | ATLANTA
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State | GA
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Zip | 30316-1466
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Country | US
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Telephone | 404-584-6288
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Fax | 404-584-6292
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Provider Business Mailing Address
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Address Line | PO BOX 18187
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City | ATLANTA
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State | GA
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Zip | 30316-0187
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Country | US
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Telephone | 404-584-6288
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Fax | 404-584-6292
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Authorized Official
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Title or Position | CEO
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Name | MS. BERNADINE BROWN
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Credential |
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Telephone | 404-584-6288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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