Provider Demographics
NPI:1023817863
Name:GOIFUL LIVING
Entity type:Organization
Organization Name:GOIFUL LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MONTRELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDOUGALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-561-7411
Mailing Address - Street 1:PO BOX 1444
Mailing Address - Street 2:
Mailing Address - City:DUNN
Mailing Address - State:NC
Mailing Address - Zip Code:28335-1444
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 OLD FORTE TRL
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NC
Practice Address - Zip Code:28390-7427
Practice Address - Country:US
Practice Address - Phone:919-561-7411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREAT OVERCOMERS INCORPERATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty