Healthcare Provider Details

I. General information

NPI: 1346167905
Provider Name (Legal Business Name): LIFENEST HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4229 LAFAYETTE CENTER DR STE 1300-B
CHANTILLY VA
20151-1261
US

IV. Provider business mailing address

4229 LAFAYETTE CENTER DR STE 1300-B
CHANTILLY VA
20151-1261
US

V. Phone/Fax

Practice location:
  • Phone: 540-515-4534
  • Fax: 877-567-7947
Mailing address:
  • Phone: 540-515-4534
  • Fax: 877-567-7947

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KALYAN CHANDRA S CHAGANTI
Title or Position: OWNER
Credential:
Phone: 540-515-4534