Individual provider · Type 1 NPI
Devan Lamonte Strange Jr.
Assisted Living Facility · Canton, MS
NPI number
1114490323
Active
Practice location
177 Miggins Rd
Canton, MS 39046-9162
Mailing address
4780 I 55 N Ste 100
Jackson, MS 39211-5583
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Driver | 172A00000X | 801131590 (MS) |
| Assisted Living Facility Primary | 310400000X | None listed |
Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
About NPI 1114490323
Devan Lamonte Strange Jr.'s National Provider Identifier is 1114490323, issued on Jan 10, 2019. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Canton, MS. The record was last updated on Jun 11, 2021.