# SPOKANE LIVING WATER ADULT FAMILY HOME LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013884758
- **Authorized official:** DMITRIY LISOVENKO RN (OWNER)
- **Authorized official phone:** (509) 979-1041

## Contact information

- **Practice address:** 1728 N STONE ST, SPOKANE, WA 99207-5253
- **Practice address phone:** (509) 979-1041
- **Practice address fax:** (509) 824-7178
- **Mailing address:** 1728 N STONE ST, SPOKANE, WA 99207-5253
- **Mailing address phone:** (509) 979-1041
- **Mailing address fax:** (509) 824-7178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/18/2025
- **Last updated:** 10/18/2025