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General NPI Number Information
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NPI Number | 1932959798
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Entity Type | Organization
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Legal Business Name | UNLIMITED POTENTIAL, INC.
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Dates
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Enumeration Date | 03/25/2024
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Last Update Date | 03/25/2024
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Provider Practice Location Address
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Address Line | 3146 E WIER AVE RM 34
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City | PHOENIX
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State | AZ
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Zip | 85040-2754
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Country | US
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Telephone | 602-305-4742
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8814
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City | PHOENIX
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State | AZ
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Zip | 85066-8814
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Country | US
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Telephone | 602-305-4742
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. EMMA NELLY VIERA
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Credential | PHD, MPH
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Telephone | 602-615-0994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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