NPI 1134475635

Change Academy Lake of the Ozarks

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Lake Ozark, MO

Practice location

Address: 130 Calo Ln, Lake Ozark, MO 65049-9208
Phone: (573) 200-1605

Authorised official

Name: Michael Koehler
Title: Recreation Therapy Director
Phone: (866) 753-1374

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Missouri →

Registry record

NPI: 1134475635
Entity type: Organization
NPI issued: 2 Aug 2012
Record last updated: 2 Aug 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.