CHANGE ACADEMY AT LAKE OF THE OZARKS – NPI #1316130784
Residential Treatment Facility, Emotionally Disturbed Children

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.

CHANGE ACADEMY AT LAKE OF THE OZARKS is a residential treatment facility located in LAKE OZARK, MO. NPPES has assigned the NPI number 1316130784 to CHANGE ACADEMY AT LAKE OF THE OZARKS on August 20, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 322D00000X from the Health Care Provider Taxonomy code set, which is classified as Residential Treatment Facility, Emotionally Disturbed Children.

The NPI profile was last updated on May 21, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHANGE ACADEMY AT LAKE OF THE OZARKS below.

NPI Profile for
CHANGE ACADEMY AT LAKE OF THE OZARKS

NPI Number
1316130784
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHANGE ACADEMY AT LAKE OF THE OZARKS
Primary location
130 CALO LANE
LAKE OZARK, MO 65049
Phone: (573) 365-2221 Fax: (573) 365-2224
Mailing address
5500 MING AVE STE 410
BAKERSFIELD, CA 93309-4631
Phone: (661) 622-4132 Fax: (573) 365-2224
Organization Subpart
No
Authorized Official
SHARNELL SPENCER
CREDENTIALING MANAGER
Phone: (661) 239-6923
Updated
Certification Date
May 21, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for CHANGE ACADEMY AT LAKE OF THE OZARKS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidAR179084125
medicaidNC3404547
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
322D00000X
- Residential Treatment Facility, Emotionally Disturbed Children (Primary)
323P00000X
- Psychiatric Residential Treatment Facility
MO 105270

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.