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1457775744
DIVINE RESIDENTIAL CARE AGENCY, LLC
WINONA, MS
NPI
1457775744
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Entity Type
Organization
Authorized Contact
DAPHAINE MOORE BLAKES
CEO
901-281-2747
Organization Subpart ?
No
Primary Taxonomy
310400000X Assisted Living Facility
Enumeration Date
2014-02-07
Last Update Date
2014-02-07
Business Address
DIVINE RESIDENTIAL CARE AGENCY, LLC
506 SPEEDWAY AVE
WINONA, MS 38967-1816
Phone number: 901-281-2747
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Mailing Address
DIVINE RESIDENTIAL CARE AGENCY, LLC
7061 FOXHALL DR
HORN LAKE, MS 38637-1269
Phone number: 901-281-2747
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