Organization
UNLEASHED PHOENIX CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDNA ELLISON (EXECUTIVE DIRECTOR)
(623) 216-1237
Entity
Organization
Contact information
Practice address
11 E SUPERIOR ST STE 543, DULUTH, MN 55802-2089
(218) 409-6576
Mailing address
11 E SUPERIOR ST STE 543, DULUTH, MN 55802-2089
(218) 409-6576
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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