Provider Demographics
NPI:1437288230
Name:FSL PROGRAMS
Entity Type:Organization
Organization Name:FSL PROGRAMS
Other - Org Name:CATHOLIC OUTREACH CENTER
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 1:12301 W BELL RD
Practice Address - Street 2:SUITE A-103
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-9705
Practice Address - Country:US
Practice Address - Phone:623-933-4300
Practice Address - Fax:623-933-1673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable