Provider Demographics
NPI:1245396845
Name:FSL PROGRAMS
Entity Type:Organization
Organization Name:FSL PROGRAMS
Other - Org Name:CARE BY DESIGN - YAVAPAI
Other - Org Type:Other Name
Authorized Official - Title/Position:EXEC ASST
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:INIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-285-0505
Mailing Address - Street 1:1201 E THOMAS RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5734
Mailing Address - Country:US
Mailing Address - Phone:602-285-1800
Mailing Address - Fax:602-285-1838
Practice Address - Street 1:3609 CROSSINGS DR
Practice Address - Street 2:SUITE A
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305-7133
Practice Address - Country:US
Practice Address - Phone:928-443-5531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management