Good Life Services LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

GOOD LIFE SERVICES LLC

Practice address

79 State St
Gorham, ME 04038-1012

Phone

(207) 894-0537

NPI assigned

Nov 15, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mutombo Mutombo

Title

Owner

Phone

(220) 789-4053

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573776000000",
    "number": "1124663919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 STATE ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381012",
            "telephone_number": "207-894-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 STATE ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381012",
            "telephone_number": "207-894-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LIFE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-15",
        "last_updated": "2019-11-15",
        "status": "A",
        "authorized_official_last_name": "MUTOMBO",
        "authorized_official_first_name": "MUTOMBO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "220-789-4053"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.