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Organization
CHANGE ACADEMY LAKE OF THE OZARKS
Active
Organization
CHANGE ACADEMY LAKE OF THE OZARKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM PAGE (THERAPIST)
(573) 200-1608
Entity
Organization
Contact information
Practice address
130 CALO LN, LAKE OZARK, MO 65049-9208
(866) 753-1373
Mailing address
130 CALO LN, LAKE OZARK, MO 65049-9208
(866) 753-1373
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
2012008387
MO
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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