CHANGE ACADEMY AT LAKE OF THE OZARKS
NPI 1215705215
Residential Treatment Facility, Emotionally Disturbed Children in Greeley, CO

NPI Status: Active since December 19, 2023

Contact Information

5401 W 9TH ST
GREELEY, CO
ZIP 80634
Phone: (720) 372-0031

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  • Organization
  • Residential Treatment Facility, Emotiona...
  • CLIA Number: 06D2297155
  • CLIA Cert. Type: Other - MENTAL HEALTH RESIDENCY
  • CLIA Exp. Date: 01-10-2026

About CHANGE ACADEMY AT LAKE OF THE OZARKS

This page provides the complete NPI Profile along with additional information for Change Academy At Lake Of The Ozarks, a provider established in Greeley, Colorado operating as a Residential Treatment Facility, Emotionally Disturbed Children. The healthcare provider is registered in the NPI registry with number 1215705215 assigned on December 2023. The practitioner's primary taxonomy code is 322D00000X. The provider is registered as an organization and their NPI record was last updated May 2025. The provider's . The authorized official of this NPI record is Sharnell Spencer (Credentialing Manager)

NPI
1215705215
Provider Legal Name
CHANGE ACADEMY AT LAKE OF THE OZARKS
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
5401 W 9TH ST GREELEY, CO 80634
Location Phone
(720) 372-0031
Mailing Address
5500 MING AVE STE 410 BAKERSFIELD, CA 93309
Mailing Phone
(661) 622-4132
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
12-19-2023
Last Update Date
05-15-2025
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Residential Treatment Facility, Emotionally Disturbed Children

Taxonomy Code
322D00000X
Type
Residential Treatment Facilities
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SHARNELL SPENCER

Authorized Official Title
CREDENTIALING MANAGER
Authorized Official Phone
(661) 239-6923

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
06D2297155
Facility Type
Other - MENTAL HEALTH RESIDENCY
Certificate Effective Date
January 11, 2024
Certificate Expiration Date
January 10, 2026
Laboratory Director
RICK A. PLISZKA
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Change Academy At Lake Of The Ozarks to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1215705215
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
22251401022
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 2 + 2 + 5 + 1 + 4 + 0 + 1 + 0 + 2 + 2 + 24 = 45
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
50 - 45 = 55

The NPI number 1215705215 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 3 providers are registered at the same or nearby location.

KOKUA CO LLC

Substance Abuse Rehabilitation Facility

(Substance Abuse Treatment, Children)

5401 W 9TH ST
GREELEY, CO
ZIP 80634

(877) 302-5022

RED MOUNTAIN COLORADO, LLC

Substance Abuse Rehabilitation Facility

(Substance Abuse Treatment, Children)

5401 W 9TH ST
GREELEY, CO
ZIP 80634

(970) 631-6364

GIGI GIBSON KING RN

Registered Nurse

(Psychiatric/Mental Health)

5401 W 9TH ST
GREELEY, CO
ZIP 80634

(303) 378-4462

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215705215, enumerated as an "organization" on December 19, 2023.

The provider is located at 5401 W 9TH ST GREELEY, CO 80634 and the phone number is (720) 372-0031.

Residential Treatment Facility, Emotionally Disturbed Children with taxonomy code 322D00000X.