Provider Demographics
NPI:1184388043
Name:THE GOOD GOOD LIFE OCCUPATIONAL THERAPY, LLC
Entity type:Organization
Organization Name:THE GOOD GOOD LIFE OCCUPATIONAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:LINDSEY
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:OTD, OTR/L
Authorized Official - Phone:321-543-6939
Mailing Address - Street 1:3250 CONSERVATION PL APT 203
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32934-8770
Mailing Address - Country:US
Mailing Address - Phone:321-543-6939
Mailing Address - Fax:
Practice Address - Street 1:3250 CONSERVATION PL APT 203
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32934-8770
Practice Address - Country:US
Practice Address - Phone:321-543-6939
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-27
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health