Organization
FSL PROGRAMS
Active
Other names
Transitional Care Program
Organization subpart
No
Provider details
NPI number
Authorized official
ANNETTE INIGUEZ (EXECUTIVE ASSISTANT)
(602) 285-1800
Entity
Organization
Contact information
Practice address
1201 E THOMAS RD, PHOENIX, AZ 85014-5734
(602) 285-1800
(602) 285-1838
Mailing address
1201 E THOMAS RD, PHOENIX, AZ 85014-5734
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HHA0110
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
652223
AHCCCS
AZ
Enumeration date
06/13/2012
Last updated
07/06/2012
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