CHANGE ACADEMY AT LAKE OF THE OZARKS
NPI 1225722093
Clinic/Center - Mental Health (Including Community Mental Health Center) in San Rafael, CA

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 1225722093. It was assigned to this organization in the NPPES registry on June 5, 2023. The provider is doing business as Embark Behavioral Health.

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

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Active since June 05, 2023

4000 CIVIC CENTER DR STE 102, SAN RAFAEL, CA 94903(415) 578-5727 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 21, 2025, Jun 5, 2023 (2 updates tracked since 2023).

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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 1225722093), doing business as Embark Behavioral Health, is a healthcare organization registered as a mental health (including community mental health center) in San Rafael, California and active in the NPI registry since June 2023. The organization lists Sharnell Spencer, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1225722093

Entity TypeOrganization

Primary Taxonomy261QM0801X

Legal Business NameCHANGE ACADEMY AT LAKE OF THE OZARKS

Location Address4000 CIVIC CENTER DR STE 102San Rafael, CA 94903-4171

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

Phone(415) 578-5727

Organization SubpartYes

Authorized OfficialSharnell SpencerCredentialing Manager · (661) 239-6923

Enumeration DateJune 5, 2023

Last NPPES UpdateMay 21, 20252 updates tracked since enumeration

NPPES CertifiedMay 21, 2025

✔ NPI 1225722093 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities

Taxonomy Code261QM0801X

4000 CIVIC CENTER DR STE 102, San Rafael, CA 94903

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Other Names 1

Doing Business AsEmbark Behavioral Health

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

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

The NPI number for Change Academy At Lake Of The Ozarks is 1225722093. It was assigned to this organization in the NPPES registry on June 5, 2023. The provider is doing business as Embark Behavioral Health.

Where is Change Academy At Lake Of The Ozarks located?

Change Academy At Lake Of The Ozarks is located at 4000 Civic Center Dr Ste 102, San Rafael, CA 94903. The listed phone number is (415) 578-5727.

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

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Change Academy At Lake Of The Ozarks was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.