Organization · NPI-2

Fly Like An Eagle Outreach, INC.

Peer Specialist · Long Beach, CA

NPI number1972332674
StatusActive
Last updated in NPPESOct 19, 2026

Details

NPI
1972332674
Entity type
Organization (NPI-2)
Legal business name
Fly Like An Eagle Outreach, INC.
Organization subpart
No
Enumeration date
Jul 31, 2024
Certification date
Oct 19, 2026
Last updated
Oct 19, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
175T00000X Peer Specialist––Yes
251300000X Local Education Agency (LEA)––
251B00000X Case Management––
251C00000X Day Training, Developmentally Disabled Services––
251S00000X Community/Behavioral Health––
251T00000X PACE Provider Organization––
253Z00000X In Home Supportive Care––

Other names

  • Fly Like An Eagle Outreach, INC. (Doing Business As)

Practice location

120 E 3rd St # 208
Long Beach, CA 90802-3138

Phone 310-945-8305

Mailing address

120 E 3rd St Ste 208
Long Beach, CA 90802-3138

Phone 310-945-8305

Other practice locations

3317 E 8th St
Long Beach, CA 90804-5008

Phone 310-945-8305

Authorized official

Jolly Glover
Executive Director
3109458305

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Peer Specialist providers in Long Beach, CA