Organization
FEATHERS OF FLIGHT L.L.C.
Active
Organization
FEATHERS OF FLIGHT L.L.C.
Active
Other names
Feathers of Flight
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. STEVEN RAY ISHAM M.A. / L.B.S.W (CLINICAL DIRECTOR)
(480) 471-7179
Entity
Organization
Contact information
Practice address
30872 N ROYAL OAK WAY, QUEEN CREEK, AZ 85243-4173
(480) 560-5518
(480) 383-6233
Mailing address
30872 N ROYAL OAK WAY, QUEEN CREEK, AZ 85243-4173
(480) 560-5518
(480) 383-6233
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-3282
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
251S00000X
—
AZ
Enumeration date
04/22/2009
Last updated
04/22/2009
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