| Life Leadership Academy | |
|
927 Amador Street Vallejo CA 94510 | |
| (510) 473-2410 | |
| Not Available |
| Full Name | Life Leadership Academy |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 927 Amador Street, Vallejo, California |
| Authorized Official Name and Position | David Hartfield-dyels (CEO) |
| Authorized Official Contact | 5104732410 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Leadership Academy Po Box 572 Benicia CA 94510-0572 Ph: (510) 473-2410 | Life Leadership Academy 927 Amador Street Vallejo CA 94510 Ph: (510) 473-2410 |
| NPI Number | 1548706765 |
|---|---|
| Provider Enumeration Date | 01/11/2017 |
| Last Update Date | 11/24/2021 |
| Certification Date | 11/11/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548706765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
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