Provider Demographics
NPI:1891096087
Name:GOODLIFE CARE, LLC
Entity Type:Organization
Organization Name:GOODLIFE CARE, LLC
Other - Org Name:PK WRIGHT GROUP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-783-1415
Mailing Address - Street 1:1400 VETERANS MEMORIAL HWY SE
Mailing Address - Street 2:SUITE 134 #305
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-2945
Mailing Address - Country:US
Mailing Address - Phone:888-689-7657
Mailing Address - Fax:866-672-9398
Practice Address - Street 1:1400 VETERANS MEMORIAL HWY SE
Practice Address - Street 2:SUITE 134 #305
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-2945
Practice Address - Country:US
Practice Address - Phone:888-689-7657
Practice Address - Fax:866-672-9398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care