NPI 1114490323

Devan Lamonte Strange

Practitioner Assisted Living Facility Canton, MS

Practice location

Address: 177 Miggins Rd, Canton, MS 39046-9162
Phone: (601) 761-4315
Mailing address: 4780 I 55 N STE 100, Jackson, MS 39211-5583

Registered specialties (2)

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Driver

Other Service Providers Taxonomy 172A00000X Licence 801131590 (MS)

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Registry record

NPI: 1114490323
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Jan 2019
Record last updated: 11 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.