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UNLEASHED PHOENIX
NPI 1780280354
Community/Behavioral Health in Phoenix, AZ

Active since December 09, 2020CLIA 03D2316753 · Waiver
2538 E UNIVERSITY DR STE 165, PHOENIX, AZ 85034(232) 824-2546 Get Directions Write a Review

NPPES record last updated: April 12, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 12, 2023, Dec 9, 2020 (2 updates tracked since 2020).

About Unleashed Phoenix NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UNLEASHED PHOENIX (NPI 1780280354) is a healthcare organization registered as a community/behavioral health in Phoenix, Arizona and active in the NPI registry since December 2020. The organization holds a CLIA Waiver certificate valid through January 12, 2027 and lists Edna Ellison, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1780280354
Entity TypeOrganization
Primary Taxonomy251S00000X
Legal Business NameUNLEASHED PHOENIX CORP
Location Address2538 E UNIVERSITY DR STE 165Phoenix, AZ 85034-6905
Mailing Address2538 E University Dr Ste 165Phoenix, AZ 85034-6905 · (623) 282-4254
Phone(232) 824-2546
Organization SubpartNo
Authorized OfficialEdna EllisonExecutive Director · (623) 216-1237
Enumeration DateDecember 9, 2020
Last NPPES UpdateApril 12, 20232 updates tracked since enumeration
NPPES CertifiedApril 12, 2023
✔ NPI 1780280354 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity/Behavioral HealthAgencies
Taxonomy Code251S00000X
Definition
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
2538 E UNIVERSITY DR STE 165, Phoenix, AZ 85034
Open in Google Maps ↗

Other Names 1

Doing Business AsUnleashed Phoenix

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 03D2316753

Unleashed Phoenix Corp · Phoenix, AZ
Active · expires Jan 12, 2027
CLIA Number03D2316753
Laboratory TypeOutpatient
Certificate Effective DateJanuary 13, 2025
Certificate Expiration DateJanuary 12, 2027
Laboratory DirectorTehrani Rajael Ali
Laboratory Phone(623) 216-1237
Laboratory LocationUnleashed Phoenix Corp2538 E University Dr Ste 165, Phoenix, AZ 85034
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Unleashed Phoenix Corp's NPI number?

The NPI number for Unleashed Phoenix Corp is 1780280354. It was assigned to this organization in the NPPES registry on December 9, 2020. The provider is doing business as Unleashed Phoenix.

Where is Unleashed Phoenix Corp located?

Unleashed Phoenix Corp is located at 2538 E University Dr Ste 165, Phoenix, AZ 85034. The listed phone number is (232) 824-2546.

What is Unleashed Phoenix Corp's specialty?

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Does Unleashed Phoenix Corp hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 03D2316753) is associated with this NPI, valid through January 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Unleashed Phoenix Corp was last updated on April 12, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.