Provider Demographics
NPI:1477711364
Name:THE GOOD LIFE INC
Entity Type:Organization
Organization Name:THE GOOD LIFE INC
Other - Org Name:VISITING ANGELS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:GRADY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-823-8780
Mailing Address - Street 1:2722 N STURDEVANT ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-1645
Mailing Address - Country:US
Mailing Address - Phone:563-823-8780
Mailing Address - Fax:866-867-5420
Practice Address - Street 1:235 W 35TH ST
Practice Address - Street 2:SUITE 5B
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-6141
Practice Address - Country:US
Practice Address - Phone:563-823-8780
Practice Address - Fax:866-867-5420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health