Organization
LIFE HOME CARE INC
Active
Other names
Life Home Health Care
Organization subpart
No
Provider details
NPI number
Authorized official
YEONG SOON IM (PRESIDENT)
(703) 750-0024
Entity
Organization
Contact information
Practice address
4601 PINECREST OFFICE PARK DR UNIT H, ALEXANDRIA, VA 22312-1442
(703) 750-0024
(703) 750-0019
Mailing address
4601 PINECREST OFFICE PARK DR UNIT H, ALEXANDRIA, VA 22312-1442
(703) 750-0024
(703) 750-0019
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCO-202176
HOME CARE LICENSE
VA
Enumeration date
09/19/2019
Last updated
09/19/2019
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