Organization
LISA'S FAMILY CARE HOME LLC.
Active
Other names
Comfort Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLEG WILLIAM DINOVETSKIY (ADMINISTRATOR)
(828) 447-5523
Entity
Organization
Contact information
Practice address
542 FOREST LAKE RD, FOREST CITY, NC 28043-5112
(828) 447-5523
(828) 286-1427
Mailing address
358 SHADY WOODS LN, RUTHERFORDTON, NC 28139-2768
(828) 447-5523
(828) 286-1427
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
920394
—
NC
Enumeration date
12/05/2006
Last updated
03/20/2019
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