Healthcare Provider Details
I. General information
NPI: 1679444210
Provider Name (Legal Business Name): GOOD LIFE HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1327 MAIN AVE
CRETE NE
68333-1505
US
IV. Provider business mailing address
1327 MAIN AVE
CRETE NE
68333-1505
US
V. Phone/Fax
- Phone: 402-251-5504
- Fax:
- Phone: 402-251-5504
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ANGELICA
DIAZ
Title or Position: OWNER
Credential:
Phone: 402-601-8036