Organization
UNLEASHED PHOENIX CORP
Active
Other names
Unleashed Phoenix
Organization subpart
No
Provider details
NPI number
Authorized official
EDNA ELLISON (EXECUTIVE DIRECTOR)
(623) 216-1237
Entity
Organization
Contact information
Practice address
2538 E UNIVERSITY DR STE 165, PHOENIX, AZ 85034-6905
(232) 824-2546
Mailing address
2538 E UNIVERSITY DR STE 165, PHOENIX, AZ 85034-6905
(623) 282-4254
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/09/2020
Last updated
04/12/2023
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