Organization
LIFE TREE CARE CENTER INC
Active
Other names
Life Tree Urgent Care, Life Tree Palliative Care, Life Tree Adult Day Care, Life Tree Assisted Living, Life Tree Wellness Care, Life Tree Nursing Home & Rehabilitation, Life Tree Home Care
Organization subpart
No
Provider details
NPI number
Authorized official
KYONG HOON KO PMP (PRESIDENT)
(434) 212-0460
Entity
Organization
Contact information
Practice address
11240 WAPLES MILL RD STE 201, FAIRFAX, VA 22030-6078
(434) 212-0460
(703) 570-7668
Mailing address
11240 WAPLES MILL RD STE 201, FAIRFAX, VA 22030-6078
(434) 212-0460
(703) 570-7668
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
311ZA0620X
Adult Care Home Facility
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
—
—
3140N1450X
Pediatric Skilled Nursing Facility
—
—
Other
Enumeration date
11/15/2024
Last updated
11/15/2024
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