LIFE TREE CARE CENTER INC NPI 1366267304

NPI Information

  • NPI: 1366267304
  • Provider Name: LIFE TREE CARE CENTER INC
  • Classification: Clinic/Center - 261QA0600X
  • Specialization: Adult Day Care
  • Entity Type: Organization
  • Address: 11240 WAPLES MILL RD STE 201
    FAIRFAX, VA
    ZIP 22030
  • Phone: (434) 212-0460

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NPI Details

LIFE TREE CARE CENTER INC is an adult day care clinic center in Fairfax, VA. LIFE TREE CARE CENTER INC NPI is 1366267304. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

11240 WAPLES MILL RD STE 201
FAIRFAX, VA
ZIP 22030-078
Phone: (434) 212-0460
Fax: (703) 570-7668

The provider's authorized official is Kyong Hoon Ko .
The authorized official title is President and has the following contact phone number (434) 212-0460.

The enumeration date for this NPI number is 11/15/2024 and was last updated on 11/15/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WH0200XRegistered NurseHome HealthNo
2251G00000XHospice Care, Community BasedNo
3251J00000XNursing CareNo
4253Z00000XIn Home Supportive CareNo
5261QA0600XClinic/CenterAdult Day CareYes
6261QP2000XClinic/CenterPhysical TherapyNo
7261QR0400XClinic/CenterRehabilitationNo
8261QU0200XClinic/CenterUrgent CareNo
9310400000XAssisted Living FacilityNo
103104A0625XAssisted Living FacilityAssisted Living, Mental IllnessNo
113104A0630XAssisted Living FacilityAssisted Living, Behavioral DisturbancesNo
12311ZA0620XCustodial Care FacilityAdult Care HomeNo
13313M00000XNursing Facility/Intermediate Care FacilityNo
14314000000XSkilled Nursing FacilityNo
153140N1450XSkilled Nursing FacilityNursing Care, PediatricNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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