CHANGE ACADEMY AT LAKE OF THE OZARKS (NPI# 1316130784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316130784 |
| Entity Type | Organization |
| Organization Name | CHANGE ACADEMY AT LAKE OF THE OZARKS |
| Practice Address |
130 Calo Lane Lake Ozark MO 65049 |
| Practice Telephone | 5733652221 |
| Practice Fax Number | 5733652224 |
| Mailing Telephone | 5733652221 |
| Mailing Fax Number | 5733652224 |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2010-03-12 |
| Authorized Official Name | DR. KENNETH MICHAEL HUEY (CHIEF EXECUTIVE OFFICIER) |
| Authorized Official Telephone | 5733652221 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 323P00000X | Psychiatric Residential Treatment Facility | 105270 | MO | Residential Treatment Facilities |
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 179084125 | 05 | |
| NC | 3404547 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225645674 | Change Academy At Lake of The Ozarks | Psychiatric Residential Treatment Facility | 5842 Highway 30, Benton, TN 37307-4734 | 2020-09-29 |
| 1659900835 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 266 South Left Fork Hobble Creek Canyon Road, Springville, UT 84663 | 2020-04-08 |
| 1902435399 | Change Academy At Lake of The Ozarks | Community/Behavioral Health | 7945 Macarthur Blvd Ste 214, Cabin John, MD 20818-1634 | 2020-04-07 |
| 1093280943 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 130 Calo Ln, Lake Ozark, MO 65049-9208 | 2018-10-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Change Academy at Lake of the Ozarks | 130 Calo Lane, Lake Ozark, MO 65049 |
| Oregon Corporations, Companies and Business Names | CHANGE ACADEMY AT LAKE OF THE OZARKS, LLC | Po Box 1810, Lake Ozark, MO 65049 |
| Street Address |
130 CALO LANE |
| City | LAKE OZARK |
| State | MO |
| Zip Code | 65049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679099725 | Embark By Calo | Counselor | 110 Crossing Drive Suite 1, Lake Ozark, MO 65049 | 2017-08-21 |
| 1184006843 | Whitney Lodge | Pharmacist | 1870-c Bagnell Blvd, Lake Ozark, MO 65049 | 2015-06-18 |
| 1083907869 | Darin Thomas Puppel | Massage Therapist | 121 Crossings W, Ste F, Lake Ozark, MO 65049 | 2011-05-26 |
| 1407011851 | The Lime In The Coconut Specialty Compounding Pharmacy, LLC | Pharmacy | 121 Crossings West, # F, Lake Ozark, MO 65049 | 2008-07-25 |
| 1821270620 | Barnes Medical Clinic PC | Clinic/Center | 121 Crossings West Drive, #5, Lake Ozark, MO 65049 | 2007-12-04 |
| 1891825592 | Karen L. Jenkins | Speech-Language Pathologist | 1571 Bagnell Dam Blvd., Box 1960, Lake Ozark, MO 65049 | 2007-03-06 |
| 1689741035 | Morrow Chiropractic Clinic PC | Chiropractor | 3225 Bagnell Dam Boulevard, Lake Ozark, MO 65049 | 2006-11-29 |
| 1891802443 | Lake Regional Medical Management, Inc | Durable Medical Equipment & Medical Supplies | 1870-c Bagnell Dam Blvd, Lake Ozark, MO 65049 | 2006-08-23 |
| 1033659545 | Marshal Morrow | Chiropractor | 3225 Bagnell Dam Boulevard, Lake Ozark, MO 65049 | 2017-03-02 |
| 1780742221 | Harold Dean Morrow | Chiropractor | 3225 Bagnell Dam Boulevard, Lake Ozark, MO 65049 | 2006-12-05 |
| Find all providers in zip 65049 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093280943 | Change Academy At Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 130 Calo Ln, Lake Ozark, MO 65049-9208 | 2018-10-08 |
| 1134475635 | Change Academy Lake of The Ozarks | Residential Treatment Facility, Emotionally Disturbed Children | 130 Calo Ln, Lake Ozark, MO 65049-9208 | 2012-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609474204 | Whetstone Boys Ranch | Residential Treatment Facility, Emotionally Disturbed Children | 6850 County Road 2660, Mountain View, MO 65548-8146 | 2020-10-15 |
| 1962995993 | The Bridge Home for Children | Residential Treatment Facility, Emotionally Disturbed Children | 6033 Swope Pkwy, Kansas City, MO 64130-4461 | 2018-06-13 |
| 1437675477 | Kybama, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 12729 Stoney Point Rd, Bonne Terre, MO 63628 | 2017-08-22 |
| 1568914927 | Clear Creek Counseling | Residential Treatment Facility, Emotionally Disturbed Children | 3646 N Farm Road 89, Willard, MO 65781-8330 | 2016-11-01 |
| 1619330578 | Farmer Grove Homesteads Incorporated | Residential Treatment Facility, Emotionally Disturbed Children | 533 E Bedford St, Marshfield, MO 65706-1218 | 2016-03-29 |
| 1720447212 | Corner Stones of Care | Residential Treatment Facility, Emotionally Disturbed Children | 300 E 36th St, Kansas City, MO 64111-1410 | 2016-02-12 |
| 1558729509 | Cayman's House of Hope, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 311 N Poplar St, Fair Play, MO 65649-9299 | 2016-02-05 |
| 1639503691 | Proverb Academy, Inc | Residential Treatment Facility, Emotionally Disturbed Children | 420 Carroll St, Morehouse, MO 63868 | 2013-08-27 |
| 1306147277 | Fair Haven Children's Home | Residential Treatment Facility, Emotionally Disturbed Children | 3132 N Fair Haven Loop, Strafford, MO 65757-8619 | 2010-11-09 |
| 1437470184 | Ozarks Teen Challenge | Residential Treatment Facility, Emotionally Disturbed Children | 512 Purist Lane, Branson West, MO 65737 | 2010-06-17 |
| Find all providers with the same taxonomy | ||||
| City | LAKE OZARK |
| Zip Code | 65049 |
Please comment or provide details below to improve the information on CHANGE ACADEMY AT LAKE OF THE OZARKS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.