Organization
CHANGE ACADEMY AT LAKE OF THE OZARKS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARNELL SPENCER (CREDENTIALING MANAGER)
(661) 239-6923
Entity
Organization
Contact information
Practice address
130 CALO LN, LAKE OZARK, MO 65049-9208
(573) 365-2221
Mailing address
5500 MING AVE STE 410, BAKERSFIELD, CA 93309-4631
(661) 622-4132
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/08/2018
Last updated
05/15/2025
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