OrganizationActive
Fsl Pathways
NPI 1508092776 · Mental Illness Community Based Residential Treatment Facility · Phoenix, AZ
Provider details
- NPI number
- 1508092776
- Entity type
- Organization
- Primary specialty
- Mental Illness Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Charnise Moore, Chief Program Officer(602) 285-1800
- License
- BH3294 (AZ)
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
13629 N 21st Dr
Phoenix, AZ 85029-1502
Phone: (602) 285-0505
Fax: (602) 285-1838
Street-level locationGet directions
Mailing address
1201 E Thomas Rd
Phoenix, AZ 85014-5734
Other names (DBA / former)
- Other name
- Agl - Canyon
Registry dates
- Enumerated
- 2009-06-02
- Last updated
- 2026-03-20
- Certified
- 2026-03-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.