MEDICARE: FSL PATHWAYS

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	320800000X	Mental Illness Community Based Residential Treatment Facility	BH1441	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	BH1441	OTHER	AZ	ADHS BHS LICENSE

General Provider Information

NPI Number	:	1811053663
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FSL PATHWAYS

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	:	14214 N 20TH WAY
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85022-4682
Country	:	US
Telephone Number	:	602-923-0828
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATIVE SERVICES MANAGER
Name	:	INDRA DAYANA GARCIA CHAVEZ
Credential	:
Telephone Number	:	602-285-0505

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	09/02/2025

Similar Medicare Providers

1801421656 — CLEANSLATE MEDICAL GROUP OF ARIZONA PLLC
Practice Location Address:

15255 N 40TH ST STE 135
PHOENIX, AZ
85032-4682

Practice Phone: 480-417-4215
Practice Fax: 833-279-7074

1124128954 — DR. RICK MICHAEL WESLEY SLOAN M.D.
Practice Location Address:

15255 N 40TH ST STE 135
PHOENIX, AZ
85032-4682

Practice Phone: 480-417-4215
Practice Fax:

1073892402 — DR. DANIEL ALLEN RODDA D.D.S.
Practice Location Address:

15255 N 40TH ST STE 141
PHOENIX, AZ
85032-4682

Practice Phone: 928-525-4642
Practice Fax:

1841761558 — BUILDING BLOCKS COUNSELING,LLC
Practice Location Address:

15255 N 40TH ST STE 135
PHOENIX, AZ
85032-4682

Practice Phone: 602-626-8112
Practice Fax:

1700438272 — LORI SUE KELLER FNP
Practice Location Address:

15255 N 40TH ST STE 135
PHOENIX, AZ
85032-4682

Practice Phone: 480-417-5289
Practice Fax:

1770208498 — DAN RODDA, DDS, PLLC
Practice Location Address:

15255 N 40TH ST STE 141
PHOENIX, AZ
85032-4682

Practice Phone: 928-525-4642
Practice Fax:

Directions to “FSL PATHWAYS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.