NPIMap

Organization Active NPI

Change Academy at Lake of the Ozarks

Doing business as Embark Behavioral Health

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Bend, OR
National Provider Identifier
1194437004
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X
Legal business name
CHANGE ACADEMY AT LAKE OF THE OZARKS
Doing business as
Embark Behavioral Health
Practice address
22022 Nelson Rd
Bend, OR 97701-9790
Phone
(541) 318-1676
NPI assigned
Dec 22, 2022
Last updated
Apr 28, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
CHANGE ACADEMY AT LAKE OF THE OZARKSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sharnell Spencer
Title
Credentialing Manager
Phone
(661) 239-6923

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X NU Primary

Addresses

Primary practice location

22022 Nelson Rd
Bend, OR 97701-9790

Mailing address

5500 Ming Ave Ste 410
Bakersfield, CA 93309-4631
Phone (661) 622-4132

Other practice location 1

63140 Dickey Rd
Bend, OR 97701-9742
Phone (541) 318-1676

Other names 1

  • Embark Behavioral Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Change Academy at Lake of the Ozarks39 organizations share this tax ID, including this one
Part of
Change Academy at Lake of the Ozarks

Other organizations with this tax ID 38

Organizations that report the same tax identification number in the National Provider Directory.

View all 38

Locations

63140 Dickey Rd
Bend, OR 97701
Phone (320) 237-3070

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1777334400000",
    "number": "1194437004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MING AVE STE 410",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933094631",
            "telephone_number": "661-622-4132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22022 NELSON RD",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977019790",
            "telephone_number": "541-318-1676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "63140 Dickey Rd",
            "address_purpose": "LOCATION",
            "city": "Bend",
            "state": "OR",
            "postal_code": "977019742",
            "country_code": "US",
            "telephone_number": "541-318-1676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHANGE ACADEMY AT LAKE OF THE OZARKS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHANGE ACADEMY AT LAKE OF THE OZARKS",
        "enumeration_date": "2022-12-22",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "SHARNELL",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "661-239-6923"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Embark Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.