MEDICARE: IMANI ENTERPRISES DBA A L NURSING HOME CARE AGENCY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251E00000X	Home Health Agency
2	251J00000X	Nursing Care Agency
3	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1346515137
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IMANI ENTERPRISES DBA A L NURSING HOME CARE AGENCY

Provider Business Mailing Address
First Line	:	1348 WEST GATE CENTER DRIVE
Second Line	:	SUITE 207
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-2984
Country	:	US
Telephone Number	:	336-287-3291
Fax Number	:	336-499-0781

Provider Business Practice Location Address
First Line	:	1348 WEST GATE CENTER DRIVE
Second Line	:	SUITE 207
City	:	WINSTON SALEM
State	:	NC
Zip	:	27103-2984
Country	:	US
Telephone Number	:	336-287-3291
Fax Number	:	336-499-0781

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ANNA JOHN SIMTAJI
Credential	:	RN
Telephone Number	:	336-287-3291

Provider Enumeration Date	:	03/13/2012
Last Update Date	:	01/31/2025

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