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Organization

FSL PROGRAMS

Active
Other names
ADHC - Santa Maria
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ANNETTE INIGUEZ (EXEC ASSISTANT)
(602) 285-0505
Entity
Organization

Contact information

Practice address
3801 E GREENWAY RD, PHOENIX, AZ 85032-4627
(602) 482-6070
(602) 482-0732
Mailing address
1201 E THOMAS RD, PHOENIX, AZ 85014-5734
(602) 285-1800
(602) 285-1838

Taxonomy

Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
ADHC-040
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
572413
AZ
01
ADHC-040
ADHS LICENSE#
AZ
01
BH-1039
ADHS BEHAVIORAL
AZ
Enumeration date
12/27/2006
Last updated
08/22/2020
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