Provider Demographics
NPI:1386184901
Name:GOOD LIFE ADVOCATES, LLC
Entity Type:Organization
Organization Name:GOOD LIFE ADVOCATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:FLOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:270-945-2114
Mailing Address - Street 1:110 CHASE WAY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-7827
Mailing Address - Country:US
Mailing Address - Phone:270-763-0232
Mailing Address - Fax:270-763-9920
Practice Address - Street 1:509 WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3741
Practice Address - Country:US
Practice Address - Phone:270-945-2114
Practice Address - Fax:270-763-9920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-01
Last Update Date:2017-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
KY800234251S00000X
KY810537251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management