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General NPI Number Information
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NPI Number | 1639703879
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Entity Type | Organization
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Legal Business Name | IMANI MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 18672 E OLD BEAU TRL
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-3521
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Country | US
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Telephone | 515-419-5096
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Fax |
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Provider Business Mailing Address
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Address Line | 18672 E OLD BEAU TRL
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-3521
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Country | US
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Telephone | 515-419-5096
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOANNE C ROP
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Credential |
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Telephone | 515-419-5096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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