Organization
D&A FAMILY CARE HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASMANDA LACEWELL (OWNER)
(910) 830-5039
Entity
Organization
Contact information
Practice address
15 GUM AVE, BOLTON, NC 28423
(910) 830-5039
(888) 633-7817
Mailing address
PO BOX 336, RIEGELWOOD, NC 28456-0336
(888) 633-7817
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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