Organization
GOODLIFE RESIDENCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHAWANDA D CLAY NP (CEO)
(615) 506-5164
Entity
Organization
Contact information
Practice address
545 MCCRORY CREEK RD, NASHVILLE, TN 37214-3418
(615) 506-5164
Mailing address
PO BOX 331486, NASHVILLE, TN 37203-7514
(615) 506-5164
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
0522057
TN
Other
Enumeration date
10/17/2012
Last updated
10/17/2012
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