MEDICARE: FEEL GOOD LOOK GOOD 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
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1225742869	OTHER	VA	BEHAVIORAL HEALTH

General Provider Information

NPI Number	:	1881308344
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEEL GOOD LOOK GOOD LLC

Provider Business Mailing Address
First Line	:	5101 OLD MAIN ST APT 309
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23231-3011
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5101 OLD MAIN ST APT 309
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23231-3011
Country	:	US
Telephone Number	:	678-368-7456
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER & CEO
Name	:	MS. TANISHA MURRAY
Credential	:
Telephone Number	:	678-368-7456

Provider Enumeration Date	:	01/10/2023
Last Update Date	:	01/10/2023

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Directions to “FEEL GOOD LOOK GOOD LLC ” Practice Location

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