Organization
CHANGE ACADEMY AT LAKE OF THE OZARKS
Active
Parent organization
CHANGE ACADEMY AT LAKE OF THE OZARKS
Other names
Embark Behavioral Health - TH
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
5842 HIGHWAY 30, BENTON, TN 37307-4734
(480) 550-9281
Mailing address
5500 MING AVE STE 410, BAKERSFIELD, CA 93309-4631
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
10/23/2024
Last updated
05/21/2025
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