Unleashed Phoenix Corp

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

UNLEASHED PHOENIX CORP

Doing business as

Unleashed Phoenix

Practice address

2538 E University Dr Ste 165
Phoenix, AZ 85034-6905

Phone

(232) 824-2546

NPI assigned

Dec 9, 2020

Last updated

Apr 12, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Edna Ellison

Title

Executive Director

Phone

(623) 216-1237

Specialties & licenses 1

Addresses

Other names 1

• Unleashed Phoenix Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Unleashed Phoenix2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Unleashed Phoenix Corp

  • Community/Behavioral Health Agency
  • Duluth, MN
  • NPI 1841172087
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1780280354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2538 E UNIVERSITY DR STE 165",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850346905",
            "telephone_number": "623-282-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2538 E UNIVERSITY DR STE 165",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850346905",
            "telephone_number": "232-824-2546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNLEASHED PHOENIX CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "ELLISON",
        "authorized_official_first_name": "EDNA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "623-216-1237"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Unleashed Phoenix",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Unleashed Phoenix",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Universal Anesthesia Associates, PLLC
• Universal Healthcare Solutions LLC
• Universal in-Home Supportive Serivices
• University Imaging LLC
• University Sports Medicine PC
• Unlimited Potential, Inc.
• Unlimited Smiles
• Yigit Unlu, M.D.
• Unmerited Favor Special Care LLC
• Unmerited Favor Special Care LLC

• Community/Behavioral Health Agency in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Community/Behavioral Health Agency in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.