Provider Demographics
NPI:1699357715
Name:GOOD LIFE PARTNERS LLC
Entity Type:Organization
Organization Name:GOOD LIFE PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID BILLER
Authorized Official - Prefix:
Authorized Official - First Name:CASSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MECHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-650-2084
Mailing Address - Street 1:37 N 1470 W
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501
Mailing Address - Country:US
Mailing Address - Phone:435-650-5109
Mailing Address - Fax:
Practice Address - Street 1:1025 W 470 N
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4238
Practice Address - Country:US
Practice Address - Phone:435-650-5109
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GOOD LIFE SENIOR LIVING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility