# LONGLIVE HEALTH CARE LLC

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

## Provider details

- **NPI number:** 1184468407
- **Authorized official:** MICHAEL PARK (MANAGER)
- **Authorized official phone:** (571) 633-5900

## Contact information

- **Practice address:** 10304 EATON PL STE 100, FAIRFAX, VA 22030-2221
- **Practice address phone:** (703) 942-9400
- **Practice address fax:** (703) 942-9700
- **Mailing address:** 10304 EATON PL STE 100, FAIRFAX, VA 22030-2221
- **Mailing address phone:** (703) 942-9400
- **Mailing address fax:** (703) 942-9700

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 06/21/2024
- **Last updated:** 06/21/2024