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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