Healthcare Provider Details

I. General information

NPI: 1922338227
Provider Name (Legal Business Name): FSL PATHWAYS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2010
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

916 E WATSON DR
TEMPE AZ
85283-3031
US

IV. Provider business mailing address

1201 E THOMAS RD
PHOENIX AZ
85014-5734
US

V. Phone/Fax

Practice location:
  • Phone: 602-285-0505
  • Fax: 602-285-1838
Mailing address:
  • Phone: 602-285-0505
  • Fax: 602-285-1838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberBHS3482
License Number StateAZ

VIII. Authorized Official

Name: INDRA DAYANA GARCIA CHAVEZ
Title or Position: ADMINISTRATIVE SERVICES MANAGER
Credential:
Phone: 602-285-0505