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Organization
INNERCHANGE LAKE HOUSE, LLC
Active
Organization
INNERCHANGE LAKE HOUSE, LLC
Active
Other names
Lake House Academy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA J BROWN (VP OF REVENUE CYCLE MANAGEMENT)
(661) 829-4060
Entity
Organization
Contact information
Practice address
447 LILY PAD LN, FLAT ROCK, NC 28731-9503
(435) 229-5498
Mailing address
5500 MING AVE STE 410, BAKERSFIELD, CA 93309-4631
(661) 622-4132
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
11/29/2023
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