# CHANGE ACADEMY AT LAKE OF THE OZARKS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093280943
- **Authorized official:** SHARNELL SPENCER (CREDENTIALING MANAGER)
- **Authorized official phone:** (661) 239-6923

## Contact information

- **Practice address:** 130 CALO LN, LAKE OZARK, MO 65049-9208
- **Practice address phone:** (573) 365-2221
- **Mailing address:** 5500 MING AVE STE 410, BAKERSFIELD, CA 93309-4631
- **Mailing address phone:** (661) 622-4132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 10/08/2018
- **Last updated:** 05/15/2025