NPI 1962005108

Change Academy at Lake of the Ozarks

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Benton, TN

Practice location

Address: 5842 Highway 30, Benton, TN 37307-4734
Phone: (505) 205-5819
Mailing address: 5500 Ming Ave STE 410, Bakersfield, CA 93309-4631

Authorised official

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

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

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

Registry record

NPI: 1962005108
Entity type: Organization
NPI issued: 19 Nov 2020
Record last updated: 21 May 2025

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.