OrganizationActive
Divine Residential Care Agency, LLC
NPI 1457775744 · Assisted Living Facility · Winona, MS
Provider details
- NPI number
- 1457775744
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Authorized official
- Daphaine Moore Blakes, Ceo
Practice location
506 Speedway Ave
Winona, MS 38967-1816
Phone: (901) 281-2747
Fax: (662) 470-5771
Mailing address
7061 Foxhall Dr
Horn Lake, MS 38637-1269
Registry dates
- Enumerated
- 2014-02-07
- Last updated
- 2014-02-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.