Good Life Corporation

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

2377-01-001 Issued in VA

Legal business name

GOOD LIFE CORPORATION

Practice address

178 Early St
New Market, VA 22844-9600

Phone

(540) 740-4688

Fax

(540) 740-8808

NPI assigned

Oct 21, 2016

Last updated

Oct 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Clif Macdonald

Title

Owner

Phone

(540) 740-4688

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1447701750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 EARLY ST",
            "city": "NEW MARKET",
            "state": "VA",
            "postal_code": "228449600",
            "telephone_number": "540-740-4688",
            "fax_number": "540-740-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 EARLY ST",
            "city": "NEW MARKET",
            "state": "VA",
            "postal_code": "228449600",
            "telephone_number": "540-740-4688",
            "fax_number": "540-740-8808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LIFE CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "MACDONALD",
        "authorized_official_first_name": "CLIF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "540-740-4688",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "VA",
            "license": "2377-01-001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Coppola
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• James Randall Fansler, RPH
• Lindsay Danielle Good, FNP-BC
• Gary N Hampton, PTA
• Michael Harley, PT, DPT
• Jeffrey S Burns DDS, PC
• Randy Pilonia Joven, PT

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Market, VA
• Providers in New Market, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.