Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Life Tree Care Center Inc

Organization Home Health Registered Nurse · NPI 1366267304

Life Tree Care Center Inc is a Home Health Registered Nurse in Fairfax, Virginia. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
15
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11240 Waples Mill Rd Ste 201
Fairfax, VA 22030-6078
Phone: (434) 212-0460
Fax: (703) 570-7668
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Day Care Clinic/Center (primary) Taxonomy 261QA0600X
Home Health Registered Nurse Taxonomy 163WH0200X
Community Based Hospice Care Agency Taxonomy 251G00000X
Nursing Care Agency Taxonomy 251J00000X
In Home Supportive Care Agency Taxonomy 253Z00000X
Physical Therapy Clinic/Center Taxonomy 261QP2000X
Rehabilitation Clinic/Center Taxonomy 261QR0400X
Urgent Care Clinic/Center Taxonomy 261QU0200X
Assisted Living Facility Taxonomy 310400000X
Assisted Living Facility (Mental Illness) Taxonomy 3104A0625X
Assisted Living Facility (Behavioral Disturbances) Taxonomy 3104A0630X
Adult Care Home Facility Taxonomy 311ZA0620X
Nursing Facility/Intermediate Care Facility Taxonomy 313M00000X
Skilled Nursing Facility Taxonomy 314000000X
Pediatric Skilled Nursing Facility Taxonomy 3140N1450X

Record details

NPI number1366267304
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kyong Ko — President · (434) 212-0460
Other names Life Tree Adult Day Care; Life Tree Assisted Living; Life Tree Home Care; Life Tree Nursing Home & Rehabilitation; Life Tree Palliative Care; Life Tree Urgent Care; Life Tree Wellness Care
NPI enumeratedNovember 15, 2024
Last updated in NPPESNovember 15, 2024
Certification dateNovember 15, 2024
Mailing address11240 Waples Mill Rd Ste 201, Fairfax, VA 22030-6078

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