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Organization
INNERCHANGE LAKE HOUSE ACADEMY
Active
Organization
INNERCHANGE LAKE HOUSE ACADEMY
Active
Parent organization
INNERCHANGE
Organization subpart
Yes
Provider details
NPI number
Legal business name
INNERCHANGE
Authorized official
HEATHER BLACK (INSURANCE SPECIALIST)
(435) 229-5498
Entity
Organization
Contact information
Practice address
447 LILLY PAD LN, FLAT ROCK, NC 28731-9503
(435) 229-5498
Mailing address
86 N UNIVERSITY AVE, #450, PROVO, UT 84601-4420
(435) 229-5498
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NULL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/27/2016
Last updated
05/27/2016
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