Provider Demographics
NPI:1124541420
Name:GOODHAIR COACHING LLC
Entity Type:Organization
Organization Name:GOODHAIR COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELONEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-304-4247
Mailing Address - Street 1:100 S BELCHER RD UNIT 8428
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33758-8300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 S BELCHER RD
Practice Address - Street 2:UNIT 8428
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33758-8300
Practice Address - Country:US
Practice Address - Phone:727-304-4247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-19
Last Update Date:2017-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case ManagementGroup - Single Specialty