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
—
—
Other
Enumeration date
05/27/2016
Last updated
05/27/2016
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