Provider Demographics
NPI:1407529910
Name:WINGS OF A FEATHER LLC
Entity Type:Organization
Organization Name:WINGS OF A FEATHER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PERRICE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CHATMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-612-9498
Mailing Address - Street 1:12906 APPLETON ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48223-3028
Mailing Address - Country:US
Mailing Address - Phone:702-612-9498
Mailing Address - Fax:
Practice Address - Street 1:12906 APPLETON ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48223-3028
Practice Address - Country:US
Practice Address - Phone:702-612-9498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management