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Organization
PREMIER LEADERSHIP ACADEMY, IN
Active
Organization
PREMIER LEADERSHIP ACADEMY, IN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRESLYN NICHOLE KELLEY-ELLIS ED.D. (PRESIDENT/CEO)
(256) 288-3281
Entity
Organization
Contact information
Practice address
2049 MAX LUTHER DR NW, SUITE A, HUNTSVILLE, AL 35810-3801
(256) 288-3281
(256) 288-3283
Mailing address
2049 MAX LUTHER DR NW, SUITE A, HUNTSVILLE, AL 35810-3801
(256) 288-3281
(256) 288-3283
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
LPC1530
AL
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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