Organization
DIVINE LIVING HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYI S MESSANVI (ADMINISTRATOR)
(608) 906-2037
Entity
Organization
Contact information
Practice address
4607 GORDON AVE, MONONA, WI 53716-1017
(608) 906-2037
Mailing address
322 MILKY WAY, MADISON, WI 53718-3026
(608) 906-2037
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
02/21/2023
Last updated
02/21/2023
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