| Change Lanes Youth Support Services | |
|
45118 13th St W Lancaster CA 93534-2156 | |
| (661) 948-5555 | |
| (661) 878-9130 |
| Full Name | Change Lanes Youth Support Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 45118 13th St W, Lancaster, California |
| Authorized Official Name and Position | Cynthia D. Hunter-spears (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6619482555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Change Lanes Youth Support Services 45118 13th Street West Unit 1d Lancaster CA 93534-2156 Ph: (661) 948-2555 | Change Lanes Youth Support Services 45118 13th St W Lancaster CA 93534-2156 Ph: (661) 948-5555 |
| NPI Number | 1407035918 |
|---|---|
| Provider Enumeration Date | 10/31/2007 |
| Last Update Date | 12/31/2021 |
| Certification Date | 12/31/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407035918 | NPI | - | NPPES |
| 1952597627 | Medicaid | CA | |
| 1669948832 | Medicaid | CA | |
| 1750686598 | Medicaid | CA | |
| 197467 | Medicaid | CA |
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