Innerchange Lake House, LLC

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

Legal business name

INNERCHANGE LAKE HOUSE, LLC

Practice address

447 Lily Pad LN
Flat Rock, NC 28731-9503

Phone

(435) 229-5498

NPI assigned

Dec 30, 2020

Last updated

Nov 29, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Laura J Brown

Title

VP of Revenue Cycle Management

Phone

(661) 829-4060

Specialties & licenses 2

Addresses

Other names 1

• Lake House Academy Other name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701216000000",
    "number": "1215524756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MING AVE STE 410",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933094631",
            "telephone_number": "661-622-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "447 LILY PAD LN",
            "city": "FLAT ROCK",
            "state": "NC",
            "postal_code": "287319503",
            "telephone_number": "435-229-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNERCHANGE LAKE HOUSE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-30",
        "last_updated": "2023-11-29",
        "certification_date": "2023-11-29",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VP OF REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "661-829-4060",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake House Academy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Leigh Hovendon, MD
• Linda A Hozdic, CRNP
• Kathleen Lauren Huffman
• Ingles Markets Inc (Ingles Pharmacy #177)
• Innerchange Lake House Academy
• J. Eric Dollinger, DDS, PA
• Chelsea Marie Johnson, FNP
• Kristan Leeann Johnson, NP-C
• Beverly Joan Joy, NP-C
• Just in Time FCH

• Emotionally Disturbed Childrens' Residential Treatment Facility in Flat Rock, NC
• Providers in Flat Rock, NC by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.