Provider Demographics
NPI:1982200135
Name:GOOD LIFE FOREVER INC
Entity Type:Organization
Organization Name:GOOD LIFE FOREVER INC
Other - Org Name:GOOD LIFE FOREVER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADIJAT
Authorized Official - Middle Name:T
Authorized Official - Last Name:OLAWALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-706-6914
Mailing Address - Street 1:3014 SCHULTZ MANOR LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-2430
Mailing Address - Country:US
Mailing Address - Phone:203-706-6914
Mailing Address - Fax:
Practice Address - Street 1:3014 SCHULTZ MANOR LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-2430
Practice Address - Country:US
Practice Address - Phone:203-706-6914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health