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General NPI Number Information
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NPI Number | 1063578730
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Entity Type | Organization
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Legal Business Name | FSL PATHWAYS
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Dates
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Enumeration Date | 12/28/2006
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 7145 W SIERRA VISTA DR
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City | GLENDALE
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State | AZ
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Zip | 85303-3520
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Country | US
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Telephone | 623-934-6166
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Fax |
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Provider Business Mailing Address
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Address Line | 1201 E THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85014-5734
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Country | US
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Telephone | 602-285-1800
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Fax | 602-285-1838
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Authorized Official
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Title or Position | ADMINISTRATIVE SERVICES MANAGER
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Name | INDRA DAYANA GARCIA CHAVEZ
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Credential |
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Telephone | 602-285-0505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | BH1181
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License Number State | AZ
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