National Provider Identifier Database

CHANGE ACADEMY AT LAKE OF THE OZARKS
Residential Treatment Facility, Emotionally Disturbed Children

A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.


Contact Information

CHANGE ACADEMY AT LAKE OF THE OZARKS
266 SOUTH LEFT FORK HOBBLE CREEK CANYON ROAD
SPRINGVILLE, UT84663
Phone: 866-534-7057
Fax:
Website:
Specialty Taxonomy Code
* Residential Treatment Facility, Emotionally Disturbed Children 322D00000X

* Indicates primary specialty

NPI Profile & details for CHANGE ACADEMY AT LAKE OF THE OZARKS

NPI Number 1659900835
Legal business name
LBN
CHANGE ACADEMY AT LAKE OF THE OZARKS
Authorized official SHARNELL SPENCER - (CREDENTIALING MANAGER)
Entity Organization
Organization subpart Yes
Enumeration date 04/08/2020
Last updated 05/21/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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