Organization
FSL PROGRAMS
Active
Other names
CLR - Community Living Resources
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNETTE INIGUEZ (EXECUTIVE ASSISTANT)
(602) 285-0505
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
(602) 285-1800
(602) 285-1838
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
652223
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
652223
—
AZ
Enumeration date
01/18/2007
Last updated
08/22/2020
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