Healthcare Provider Details

I. General information

NPI: 1972106656
Provider Name (Legal Business Name): LIFE LANDSCAPING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 12/24/2024
Certification Date: 12/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 N VERMONT AVE
LOS ANGELES CA
90029-1769
US

IV. Provider business mailing address

14411 TELEGRAPH RD
WHITTIER CA
90604-2909
US

V. Phone/Fax

Practice location:
  • Phone: 323-443-3225
  • Fax: 323-927-0105
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. TAREK YOUSEF
Title or Position: CEO
Credential:
Phone: 323-443-3225