| Unleashed Phoenix Corp | |
|
11 E Superior St Ste 543 Duluth MN 55802-2089 | |
| (218) 409-6576 | |
| Not Available |
| Full Name | Unleashed Phoenix Corp |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 11 E Superior St Ste 543, Duluth, Minnesota |
| Authorized Official Name and Position | Edna Ellison (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6232161237 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Unleashed Phoenix Corp 11 E Superior St Ste 543 Duluth MN 55802-2089 Ph: (218) 409-6576 | Unleashed Phoenix Corp 11 E Superior St Ste 543 Duluth MN 55802-2089 Ph: (218) 409-6576 |
| NPI Number | 1841172087 |
|---|---|
| Provider Enumeration Date | 07/21/2025 |
| Last Update Date | 07/21/2025 |
| Certification Date | 07/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841172087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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