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NPI 1801604905

NPI 1801604905 : GOOD LIFE HOME HEALTH CARE : GREENSBORO, NC

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General NPI Number Information
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    NPI Number           |    1801604905
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    Entity Type          |    Organization 
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    Legal Business Name  |    GOOD LIFE HOME HEALTH CARE 
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Dates
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    Enumeration Date     |    12/20/2024
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    Last Update Date     |    06/09/2025
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Provider Practice Location Address
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    Address Line         |    2 CENTERVIEW DR STE 39 
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    City                 |    GREENSBORO
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    State                |    NC
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    Zip                  |    27407-3708
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    Country              |    US
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    Telephone            |    336-676-4359
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2 CENTERVIEW DR STE 39 
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    City                 |    GREENSBORO
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    State                |    NC
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    Zip                  |    27407-3708
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    Country              |    US
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    Telephone            |    336-676-4359
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CHIEF EXECUTIVE OFFICER
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    Name                 |     REBECCA KIM BLACKMAN 
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    Credential           |    
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    Telephone            |    336-676-4359
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251J00000X
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    Taxonomy Name        |    Nursing Care Agency
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    261QH0100X
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    Taxonomy Name        |    Health Service Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    
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    License Number State |    
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