MEDICARE: ARIZONA ACADEMY OF LEADERSHIP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251300000X	Local Education Agency (LEA)		AZ

General Provider Information

NPI Number	:	1104010388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIZONA ACADEMY OF LEADERSHIP, INC.

Provider Business Mailing Address
First Line	:	PO BOX 22046
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85734-2046
Country	:	US
Telephone Number	:	520-940-3784
Fax Number	:	866-612-2196

Provider Business Practice Location Address
First Line	:	5660 S 12TH AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85706-3102
Country	:	US
Telephone Number	:	520-940-3784
Fax Number	:	866-612-2196

Authorized Official
Title or Position	:	PRINCIPAL
Name	:	MRS. TONYA RENEA STROZIER
Credential	:	M.ED.
Telephone Number	:	520-940-3784

Provider Enumeration Date	:	08/30/2007
Last Update Date	:	08/30/2007

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