MEDICARE: FSL PROGRAMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385H00000X	Respite Care	ADHC-040	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ADHC-040	OTHER	AZ	ADHS LICENSE#
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	BH-1039	OTHER	AZ	ADHS BEHAVIORAL

General Provider Information

NPI Number	:	1538224530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FSL PROGRAMS

Provider Business Mailing Address
First Line	:	1201 E THOMAS RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85014-5734
Country	:	US
Telephone Number	:	602-285-1800
Fax Number	:	602-285-1838

Provider Business Practice Location Address
First Line	:	3801 E GREENWAY RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85032-4627
Country	:	US
Telephone Number	:	602-482-6070
Fax Number	:	602-482-0732

Authorized Official
Title or Position	:	EXEC ASSISTANT
Name	:	MS. ANNETTE INIGUEZ
Credential	:
Telephone Number	:	602-285-0505

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	08/22/2020

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Directions to “FSL PROGRAMS ” Practice Location

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