Organization
CHANGE ACADEMY AT LAKE OF THE OZARKS
Active
Parent organization
CHANGE ACADEMY AT LAKE OF THE OZARKS
Other names
Embark Virtual at Montana
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHANGE ACADEMY AT LAKE OF THE OZARKS
Authorized official
SHARNELL SPENCER (CREDENTIALING MANAGER)
(661) 239-6923
Entity
Organization
Contact information
Practice address
77 TRAILS END RD, EUREKA, MT 59917-9332
(480) 550-9281
Mailing address
5500 MING AVE STE 410, BAKERSFIELD, CA 93309-4631
(661) 622-4132
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/09/2024
Last updated
03/05/2026
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