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Organization

DIVINE CONNECTION LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAQUANDA WATSON (DIRECTOR/MANAGER)
(662) 219-8409
Entity
Organization

Contact information

Practice address
442 HIGHWAY 1 S, GREENVILLE, MS 38701-4901
(662) 219-8409
Mailing address
213 STONE ST, GREENVILLE, MS 38703-3451
(662) 219-8409

Taxonomy

Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
2002
MS

Other

Enumeration date
04/19/2017
Last updated
04/19/2017
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