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General NPI Number Information
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NPI Number | 1902104730
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Entity Type | Organization
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Legal Business Name | IMANI FOUNDATION, INC.
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Dates
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Enumeration Date | 03/02/2011
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Last Update Date | 03/02/2011
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Provider Practice Location Address
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Address Line | 3201 ATLANTA INDUSTRIAL PKWY NW SUITE 303
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City | ATLANTA
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State | GA
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Zip | 30331-1045
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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 | 3201 ATLANTA INDUSTRIAL PKWY NW SUITE 303
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City | ATLANTA
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State | GA
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Zip | 30331-1045
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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 | CHIEF EXECUTIVE OFFICER (CEO)
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Name | MS. BERNADINE BROWN
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Credential | MS
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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 | GA
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