CHANGE ACADEMY AT LAKE OF THE OZARKS
NPI 1093280943
Residential Treatment Facility, Emotionally Disturbed Children in Lake Ozark, MO

Q: What is Change Academy At Lake Of The Ozarks's NPI number?

The NPI number for Change Academy At Lake Of The Ozarks is 1093280943. It was assigned to this organization in the NPPES registry on October 8, 2018.

Q: What is Change Academy At Lake Of The Ozarks's specialty?

The primary specialty registered for this NPI is Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.

Active since October 08, 2018

130 CALO LN, LAKE OZARK, MO 65049(573) 365-2221 Get Directions Write a Review

NPPES record last updated: May 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 15, 2025, Jun 20, 2023, Apr 3, 2023 and 3 more (6 updates tracked since 2018).

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About Change Academy At Lake Of The Ozarks NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHANGE ACADEMY AT LAKE OF THE OZARKS (NPI 1093280943) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Lake Ozark, Missouri and active in the NPI registry since October 2018. The organization lists Sharnell Spencer, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1093280943

Entity TypeOrganization

Primary Taxonomy322D00000X

Legal Business NameCHANGE ACADEMY AT LAKE OF THE OZARKS

Location Address130 CALO LNLake Ozark, MO 65049-9208

Mailing Address5500 Ming Ave Ste 410Bakersfield, CA 93309-4631 · (661) 622-4132

Phone(573) 365-2221

Organization SubpartNo

Authorized OfficialSharnell SpencerCredentialing Manager · (661) 239-6923

Enumeration DateOctober 8, 2018

Last NPPES UpdateMay 15, 20256 updates tracked since enumeration

NPPES CertifiedMay 15, 2025

✔ NPI 1093280943 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyResidential Treatment Facility, Emotionally Disturbed ChildrenResidential Treatment Facilities

Taxonomy Code322D00000X

Definition

A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.

130 CALO LN, Lake Ozark, MO 65049

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAMANTHA MARIAH BRUSH

Marriage & Family Therapist