Organization
FSL PATHWAYS
Active
Other names
AllThrive365 BHS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARNISE MOORE DRPH, MPH, CHC, CHRC (CHIEF PROGRAM OFFICER)
(602) 285-1800
Entity
Organization
Contact information
Practice address
13629 N 21ST DR, PHOENIX, AZ 85029-1502
(602) 285-0505
(602) 285-1838
Mailing address
13629 N 21ST DR, PHOENIX, AZ 85029-1502
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
BH3982
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3982
BH 3982
AZ
Enumeration date
02/13/2012
Last updated
03/20/2026
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