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Organization

CHANGE LANES YOUTH SUPPORT SERVICES

Active
Other names
Change Lanes
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CYNTHIA D. HUNTER-SPEARS MA, CATC (EXECUTIVE DIRECTOR)
(661) 948-2555
Entity
Organization

Contact information

Practice address
45118 13TH ST W, LANCASTER, CA 93534-2156
(661) 948-5555
(661) 878-9130
Mailing address
45118 13TH STREET WEST, UNIT 1D, LANCASTER, CA 93534-2156
(661) 948-2555
(661) 878-9130

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
10007140
CA
252Y00000X
Early Intervention Provider Agency
10007140
CA
305S00000X
Point of Service
10023326
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1669948832
CA
05
1750686598
CA
05
1952597627
CA
05
197467
CA
Enumeration date
10/31/2007
Last updated
12/31/2021
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