Organization Active NPI

Longlive Healthcare LLC

  • In Home Supportive Care Agency
  • Fairfax, VA
National Provider Identifier
1871224980
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
LONGLIVE HEALTHCARE LLC
Practice address
10304 Eaton PL Ste 100
Fairfax, VA 22030-2221
Phone
(571) 633-5900
NPI assigned
Jun 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Sharon Moon Park
Title
President
Phone
(716) 230-2555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

10304 Eaton PL Ste 100
Fairfax, VA 22030-2221

Mailing address

10304 Eaton PL Ste 100
Fairfax, VA 22030-2221
Phone (571) 633-5900

National Provider Directory

National Provider Directory
Tax ID family
Longlive Health Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719964800000",
    "number": "1871224980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10304 EATON PL STE 100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302221",
            "telephone_number": "571-633-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10304 EATON PL STE 100",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220302221",
            "telephone_number": "571-633-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONGLIVE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-20",
        "last_updated": "2024-07-03",
        "certification_date": "2024-06-21",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "MOON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-230-2555",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.