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General NPI Number Information
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NPI Number | 1477919140
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Entity Type | Organization
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Legal Business Name | AMERICAN LEADERSHIP ACADEMY
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Dates
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Enumeration Date | 01/11/2016
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Last Update Date | 01/11/2016
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Provider Practice Location Address
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Address Line | 4100 S LINDSAY RD STE 113
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City | GILBERT
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State | AZ
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Zip | 85297-1506
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Country | US
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Telephone | 480-397-9226
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 S LINDSAY RD STE 113
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City | GILBERT
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State | AZ
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Zip | 85297-1506
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SPECIAL EDUCATION COORDINATOR
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Name | CATHY FERGUSON
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Credential |
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Telephone | 480-397-9226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | SLPA9679
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License Number State | AZ
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