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Organization
SPOKANE LIVING WATER ADULT FAMILY HOME LLC
Active
Organization
SPOKANE LIVING WATER ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRIY LISOVENKO RN (OWNER)
(509) 979-1041
Entity
Organization
Contact information
Practice address
1728 N STONE ST, SPOKANE, WA 99207-5253
(509) 979-1041
(509) 824-7178
Mailing address
1728 N STONE ST, SPOKANE, WA 99207-5253
(509) 979-1041
(509) 824-7178
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Enumeration date
10/18/2025
Last updated
10/18/2025
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