CHANGE ACADEMY LAKE OZARK - NPI 1528469772 - Clinic/Center in Lake Ozark, MO

Q: What is Change Academy Lake Ozark's NPI number?

The NPI number for Change Academy Lake Ozark is 1528469772. It was assigned to this organization in the NPPES registry on September 8, 2014.

Q: What is Change Academy Lake Ozark's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

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About Change Academy Lake Ozark NPPES

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

CHANGE ACADEMY LAKE OZARK (NPI 1528469772) is a healthcare organization registered as a clinic/center in Lake Ozark, Missouri and active in the NPI registry since September 2014. The organization lists Denise Hagemann, Otr/l, as its authorized official.

NPPES Registry Identity

NPI1528469772

Entity TypeOrganization

Primary Taxonomy261Q00000X

Legal Business NameCHANGE ACADEMY LAKE OZARK

Location Address130 CALO LNLake Ozark, MO 65049-9208

Mailing Address130 Calo LnLake Ozark, MO 65049-9208 · (573) 365-2221 · Fax (573) 365-2224

Phone(573) 365-2221

Fax(573) 365-2224

Organization SubpartNo

Authorized OfficialDenise HagemannOtr/l · (573) 552-8007

Enumeration DateSeptember 8, 2014

Last NPPES UpdateMay 22, 2015

✔ NPI 1528469772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities

Taxonomy Code261Q00000X

License✔ Licensed in MO · 016604

Definition

A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

Also ListedHome HealthTaxonomy 251E00000X · License 016604 (MO)

Also ListedEarly Intervention Provider AgencyTaxonomy 252Y00000X · License 016604 (MO)

Also ListedPreferred Provider OrganizationTaxonomy 305R00000X · License 016604 (MO)

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