Provider Demographics
NPI:1730271263
Name:GOOD LIFE HOMECARE
Entity type:Organization
Organization Name:GOOD LIFE HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:563-332-0520
Mailing Address - Street 1:1035 LINCOLN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4198
Mailing Address - Country:US
Mailing Address - Phone:563-449-9500
Mailing Address - Fax:563-355-0263
Practice Address - Street 1:1035 LINCOLN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-4198
Practice Address - Country:US
Practice Address - Phone:563-449-9500
Practice Address - Fax:563-355-0263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0469809Medicaid