Provider Demographics
NPI:1619006640
Name:IMANI FOUNDATION
Entity Type:Organization
Organization Name:IMANI FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:BERNADINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-584-6288
Mailing Address - Street 1:PO BOX 18187
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30316-0187
Mailing Address - Country:US
Mailing Address - Phone:404-584-6288
Mailing Address - Fax:404-584-6292
Practice Address - Street 1:1074 MEMORIAL DR SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30316-1466
Practice Address - Country:US
Practice Address - Phone:404-584-6288
Practice Address - Fax:404-584-6292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management