Healthcare Provider Details

I. General information

NPI: 1881759884
Provider Name (Legal Business Name): FSL PROGRAMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 08/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7375 EAST 2ND STREET
SCOTTSDALE AZ
85251
US

IV. Provider business mailing address

1201 EAST THOMAS ROAD
PHOENIX AZ
85014
US

V. Phone/Fax

Practice location:
  • Phone: 602-532-2980
  • Fax: 480-483-3993
Mailing address:
  • Phone: 602-285-1800
  • Fax: 602-285-1838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberADHC-3208
License Number StateAZ

VIII. Authorized Official

Name: MS. ANNETTE INIGUZ
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 602-285-0505