OrganizationActive
Change Academy Lake of the Ozarks
NPI 1134475635 · Emotionally Disturbed Childrens' Residential Treatment Facility · Lake Ozark, MO
Provider details
- NPI number
- 1134475635
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Michael Koehler, Recreation Therapy Director(866) 753-1374
Specialties & taxonomies
Residential Treatment Facilities
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
130 Calo Ln
Lake Ozark, MO 65049-9208
Phone: (573) 200-1605
Street-level locationGet directions
Mailing address
130 Calo Ln
Lake Ozark, MO 65049-9208
Registry dates
- Enumerated
- 2012-08-02
- Last updated
- 2012-08-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.