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NPI Code Detail

MEDICARE: GOOD LIFE THERAPY, LLC

MEDICARE: GOOD LIFE THERAPY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist130363NV

General Provider Information

NPI Number : 1700211182
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOOD LIFE THERAPY, LLC
Provider Business Mailing Address
First Line : 850 LA SCONSA DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89138-7562
Country : US
Telephone Number : 702-526-5550
Fax Number : 702-347-7649
Provider Business Practice Location Address
First Line : 850 LA SCONSA DR
Second Line :
City : LAS VEGAS
State : NV
Zip : 89138-7562
Country : US
Telephone Number : 702-526-5550
Fax Number : 702-347-7649
Authorized Official
Title or Position : OWNER/MANAGER
Name : CORINNE TRENHOLM
Credential : OTR/L
Telephone Number : 702-526-5550
Provider Enumeration Date : 09/04/2013
Last Update Date : 06/01/2020

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Directions to “GOOD LIFE THERAPY, LLC ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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