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Imani Community Out Reach Center
Preferred Provider Organization in Kosciusko, Mississippi
NPI 1295174555

Imani Community Out Reach Center is a Preferred Provider Organization based in Kosciusko, MS. Imani Community Out Reach Center practices in Kosciusko, MS. The NPI Number for Imani Community Out Reach Center is 1295174555 and holds a License No. 7862 (Mississippi).

The current practice location address for Imani Community Out Reach Center is 301 E Jefferson St, Kosciusko, MS and can be reached out via phone at 662-289-7676.

Location: 301 E Jefferson St, Kosciusko, MS, 39090-3719
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1295174555
Provider Name
Imani Community Out Reach Center
Credential
Provider Entity Type
Organization
Address
301 E Jefferson St, Kosciusko, MS, 39090-3719
Phone Number
662-289-7676
Fax Number
Provider Enumeration Date
06/20/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
261QA0600X 01 ADULT DAY CARE
08533763 01 MS HOSPICE
172V00000X 01 MS CLINIC SOCIAL WORKER
institution
Provider Business Practice Location Address Details
Address
301 E Jefferson St
City
Kosciusko
State
Mississippi
Zip
39090-3719
Phone Number
662-289-7676
Fax Number
person
Provider Business Mailing Address Details
Address
301 E Jefferson St
City
Kosciusko
State
Mississippi
Zip
39090-3719
Phone Number
662-289-7676
Fax Number
person
Provider's Taxonomy Details 1
Type
Managed Care Organizations
Classification
Preferred Provider Organization
Speciality
-
Taxonomy
305R00000X
License No.
7862 (Mississippi)
Definition
A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
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