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
- 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
- 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
- Code Navigator
Location Map
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.
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. | |||||||||
| 1 | 2 | 1 | 5 | 7 | 0 | 5 | 2 | 1 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 2 | 5 | 14 | 0 | 10 | 2 | 2 | |
| 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 = 5 | 5 | ||||||||
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
RED MOUNTAIN COLORADO, LLC
Substance Abuse Rehabilitation Facility
(Substance Abuse Treatment, Children)
5401 W 9TH ST
GREELEY, CO
ZIP 80634
GIGI GIBSON KING RN
Registered Nurse
(Psychiatric/Mental Health)
5401 W 9TH ST
GREELEY, CO
ZIP 80634
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.
