Healthcare Provider Details

I. General information

NPI: 1518764414
Provider Name (Legal Business Name): LIFE LANSCAPING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23838 VALENCIA BLVD STE 200
VALENCIA CA
91355-2198
US

IV. Provider business mailing address

14411 TELEGRAPH RD
WHITTIER CA
90604-2909
US

V. Phone/Fax

Practice location:
  • Phone: 661-486-5055
  • Fax:
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: TAREK YOUSEF
Title or Position: CEO
Credential:
Phone: 661-486-5055