Divine Residential Services, LLC
NPI #1619793445 in Corinth, Mississippi
Provider Information
- NPI Number
- 1619793445
- Entity Type
- Organization
- Organization Name
- Divine Residential Services, LLC
- Primary Specialty
- Psychiatric Residential Treatment Facility
- Enumeration Date
- Nov 26, 2024
- Last Updated
- Jan 2, 2025
Practice Location
- Address
- 2101 PROPER ST
- City
- Corinth
- State
- Mississippi
- ZIP Code
- 38834-5247
- Phone
- (225) 810-0261
Authorized Official
- Name
- MR. BRANDON LAVAR TRIGGS, MBA
- Title
- ADMINISTRATOR
- Phone
- (225) 810-0261
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatric Residential Treatment Facility |
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