Change Academy at Lake of the Ozarks

NPI #1194437004 in Bend, Oregon

Provider Information

NPI Number: 1194437004
Entity Type: Organization
Organization Name: Change Academy at Lake of the Ozarks
Subpart: Yes (part of a larger organization)
Parent Organization: CHANGE ACADEMY AT LAKE OF THE OZARKS
Primary Specialty: Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date: Dec 22, 2022
Last Updated: May 15, 2025

Practice Location

Address: 63140 DICKEY RD
City: Bend
State: Oregon
ZIP Code: 97701-9742
Phone: (541) 318-1676

Authorized Official

Name: SHARNELL SPENCER
Title: CREDENTIALING MANAGER
Phone: (661) 239-6923

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X	Primary

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