Healthcare Provider Details

I. General information

NPI: 1346197662
Provider Name (Legal Business Name): NEXTGEN LEADERS ACADEMY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6739 PRELUDE DR
SANDY SPRINGS GA
30328-2978
US

IV. Provider business mailing address

6739 PRELUDE DR
SANDY SPRINGS GA
30328-2978
US

V. Phone/Fax

Practice location:
  • Phone: 813-990-7882
  • Fax: 813-990-7882
Mailing address:
  • Phone: 813-990-7882
  • Fax: 813-990-7882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ADDIE M BROOKS
Title or Position: FOUNDER & CEOO
Credential: BROOKS
Phone: 813-990-7882