OrganizationActive
Change Academy at Lake of the Ozarks
NPI 1346068970 · Mental Health Clinic/Center (Including Community Mental Health Center) · Meridian, ID
Provider details
- NPI number
- 1346068970
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Parent organization
- Change Academy at Lake of the Ozarks
- Organization subpart
- Yes
- Authorized official
- Sharnell Spencer, Credentialing Manager(661) 239-6923
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
943 W Overland Rd Fl 1
Meridian, ID 83642-7618
Phone: (480) 550-9281
Approximate (ZIP-level) locationGet directions
Mailing address
5500 Ming Ave Ste 410
Bakersfield, CA 93309-4631
Other names (DBA / former)
- Other name
- Embark Virtual at Idaho
- Other name
- Embark Virtual at Idaho
Registry dates
- Enumerated
- 2024-10-02
- Last updated
- 2025-05-21
- Certified
- 2025-05-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.