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Change Academy at Lake of the Ozarks

Organization Active NPI Community/Behavioral Health Agency · Benton, TN

NPI 1982425757 · NPPES record last updated May 21, 2025

Key facts

NPI
1982425757
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
CHANGE ACADEMY AT LAKE OF THE OZARKS
Practice address
5842 Highway 30
Benton, TN 37307-4734
Phone
(480) 550-9281
NPI assigned
Oct 23, 2024
Organization subpart
Yes
Parent organization (as reported)
CHANGE ACADEMY AT LAKE OF THE OZARKS

Authorized official

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

Corporate family (same tax ID) 38

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

View all 38

National Provider Directory

Tax ID family
Change Academy at Lake of the Ozarks (39 organizations share this tax ID)
Part of
Change Academy at Lake of the Ozarks

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

5842 Highway 30
Benton, TN 37307-4734

Mailing address

5500 Ming Ave Ste 410
Bakersfield, CA 93309-4631

Other names

  • Embark Behavioral Health - TH Other name

Other providers in Benton, TN

All providers in Benton, TN · Community/Behavioral Health Agency in Tennessee

Sources for this page

Verify at the official NPI Registry.