# GOOD LIFE HOME HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740856251
- **Authorized official:** LATESHA KING (CEO)
- **Authorized official phone:** (909) 332-7792

## Contact information

- **Practice address:** 1264 S WATERMAN AVE STE 27, SAN BERNARDINO, CA 92408-2848
- **Practice address phone:** (909) 332-7792
- **Practice address fax:** (909) 494-7593
- **Mailing address:** 1264 S WATERMAN AVE STE 27, SAN BERNARDINO, CA 92408-2848
- **Mailing address phone:** (909) 332-7792
- **Mailing address fax:** (909) 494-7593

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 251G00000X | Community Based Hospice Care Agency | — | NULL | — |

## Other

- **Enumeration date:** 06/03/2021
- **Last updated:** 04/14/2022