# D&A FAMILY CARE HOME LLC

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

## Provider details

- **NPI number:** 1306420294
- **Authorized official:** ASMANDA LACEWELL (OWNER)
- **Authorized official phone:** (910) 830-5039

## Contact information

- **Practice address:** 15 GUM AVE, BOLTON, NC 28423
- **Practice address phone:** (910) 830-5039
- **Practice address fax:** (888) 633-7817
- **Mailing address:** PO BOX 336, RIEGELWOOD, NC 28456-0336
- **Mailing address fax:** (888) 633-7817

## Taxonomy

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

## Other

- **Enumeration date:** 05/07/2021
- **Last updated:** 05/07/2021