Organization
GOOD LIFE THERAPY SERVICES INC.
Active
Organization
GOOD LIFE THERAPY SERVICES INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE HAVERTON LORD OTR/L (OWNER)
(970) 485-1779
Entity
Organization
Contact information
Practice address
215 14TH ST APT 14, HUNTINGTON BEACH, CA 92648-4451
(970) 485-1779
Mailing address
215 14TH ST APT 14, HUNTINGTON BEACH, CA 92648-4451
(970) 485-1779
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
10/13/2022
Last updated
10/13/2022
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