Organization
LONGLIVE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON MOON PARK (PRESIDENT)
(716) 230-2555
Entity
Organization
Contact information
Practice address
10304 EATON PL STE 100, FAIRFAX, VA 22030-2221
(571) 633-5900
Mailing address
10304 EATON PL STE 100, FAIRFAX, VA 22030-2221
(571) 633-5900
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/20/2022
Last updated
07/03/2024
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