Provider Demographics
NPI:1922851070
Name:GOOD LIFE HOME CARE LLC
Entity Type:Organization
Organization Name:GOOD LIFE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:COFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-400-7586
Mailing Address - Street 1:1098 ANN ARBOR RD W STE 648
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-2129
Mailing Address - Country:US
Mailing Address - Phone:313-400-7586
Mailing Address - Fax:
Practice Address - Street 1:1098 ANN ARBOR RD W STE 648
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-2129
Practice Address - Country:US
Practice Address - Phone:313-400-7586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care