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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