| NPI | 1407035918 |
|---|---|
| Former Legal Business Name | CHANGE LANES |
| Entity Type | Organization |
| Authorized Contact | CYNTHIA D. HUNTER-SPEARS Executive Director 661-948-2555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CA 10007140) |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency (Licence: CA 10007140) |
| 305S00000X Point of Service (Licence: CA 10023326) | |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2021-12-31 |