Provider Demographics
NPI:1700214335
Name:IMANI ADULT DAY CARE
Entity Type:Organization
Organization Name:IMANI ADULT DAY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMPHREY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:832-208-7066
Mailing Address - Street 1:5757 GUHN RD
Mailing Address - Street 2:105
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-5900
Mailing Address - Country:US
Mailing Address - Phone:281-974-4539
Mailing Address - Fax:
Practice Address - Street 1:5757 GUHN RD
Practice Address - Street 2:105
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-5900
Practice Address - Country:US
Practice Address - Phone:281-974-4539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care