CHANGE ACADEMY LAKE OF THE OZARKS
NPI 1134475635
Residential Treatment Facility, Emotionally Disturbed Children in Lake Ozark, MO

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

The NPI number for Change Academy Lake Of The Ozarks is 1134475635. It was assigned to this organization in the NPPES registry on August 2, 2012.

Q: What is Change Academy 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 August 02, 2012

130 CALO LN, LAKE OZARK, MO 65049(573) 200-1605 Get Directions Write a Review

NPPES record last updated: August 2, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Change Academy Lake Of The Ozarks NPPES

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

CHANGE ACADEMY LAKE OF THE OZARKS (NPI 1134475635) is a healthcare organization registered as a residential treatment facility, emotionally disturbed children in Lake Ozark, Missouri and active in the NPI registry since August 2012. The organization lists Michael Koehler, Recreation Therapy Director, as its authorized official.

NPPES Registry Identity

NPI1134475635

Entity TypeOrganization

Primary Taxonomy322D00000X

Legal Business NameCHANGE ACADEMY LAKE OF THE OZARKS

Location Address130 CALO LNLake Ozark, MO 65049-9208

Mailing Address130 Calo LnLake Ozark, MO 65049-9208 · (573) 200-1605

Phone(573) 200-1605

Organization SubpartNo

Authorized OfficialMichael KoehlerRecreation Therapy Director · (866) 753-1374

Enumeration DateAugust 2, 2012

✔ NPI 1134475635 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