Change Academy at Lake of the Ozarks

NPI #1346068970 in Meridian, Idaho

Provider Information

NPI Number
1346068970
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
Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date
Oct 2, 2024
Last Updated
May 21, 2025

Practice Location

Address
943 W OVERLAND RD FL 1
State
Idaho
ZIP Code
83642-7618
Phone
(480) 550-9281

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Mental Health (Including Community Mental Health Center)Mental Health (Including Community Mental Health Center)

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