Good Life Therapy Services Inc.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

GOOD LIFE THERAPY SERVICES INC.

Practice address

215 14TH St Apt 14
Huntington Beach, CA 92648-4451

Phone

(970) 485-1779

NPI assigned

Oct 13, 2022

Organization subpart

No

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

Authorized official

Name

Blake Haverton Lord, OTR/L

Title

Owner

Phone

(970) 485-1779

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1891411682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 14TH ST APT 14",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926484451",
            "telephone_number": "970-485-1779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 14TH ST APT 14",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926484451",
            "telephone_number": "970-485-1779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD LIFE THERAPY SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "LORD",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "HAVERTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-485-1779",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.