Provider Demographics
NPI:1346515137
Name:IMANI ENTERPRISES DBA A L NURSING HOME CARE AGENCY
Entity type:Organization
Organization Name:IMANI ENTERPRISES DBA A L NURSING HOME CARE AGENCY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SIMTAJI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:336-287-3291
Mailing Address - Street 1:1348 WEST GATE CENTER DRIVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-2984
Mailing Address - Country:US
Mailing Address - Phone:336-287-3291
Mailing Address - Fax:336-499-0781
Practice Address - Street 1:1348 WEST GATE CENTER DRIVE
Practice Address - Street 2:SUITE 207
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2984
Practice Address - Country:US
Practice Address - Phone:336-287-3291
Practice Address - Fax:336-499-0781
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IMANI ENTERPRISES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-03-13
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care