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Organization

ACADEMY OF LEARNING AND LEADERSHIP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. M. CAMILLE MORTIMORE PH.D (EXECUTIVE DIRECTOR)
(414) 372-3942
Entity
Organization

Contact information

Practice address
1530 W CENTER ST, MILWAUKEE, WI 53206-2101
(414) 372-3942
(414) 372-8260
Mailing address
1530 W CENTER ST, MILWAUKEE, WI 53206-2101
(414) 372-3942
(414) 372-8260

Taxonomy

Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
44241900
WI
Enumeration date
04/14/2008
Last updated
04/14/2008
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