Organization
CHANGE LANES YOUTH SUPPORT SERVICES
Active
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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