Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Health Service |
261QH0100X | |||
Clinic/Center |
261Q00000X | |||
Occupational Medicine |
261QX0100X | |||
Physical Therapy |
261QP2000X | |||
Public Health, Federal |
261QP0904X | |||
Public Health, State or Local |
261QP0905X | |||
Rehabilitation |
261QR0400X | B4[14] | Rehabilitation Agency |
| NPI # | 1902223837 |
| LBN Legal business name | GOOD LIFE CORP. |
| Authorized official | NATALIA MARTINEZ - (VICE PRESIDENT) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/28/2014 |
| Last updated | 03/28/2014 - About 12 years ago |
| Identifiers | n/a |
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