Organization · Type 2 NPI

Change Academy at Lake of the Ozarks

Emotionally Disturbed Childrens' Residential Treatment Facility · Bend, OR

NPI number 1194437004 Active

Practice location

22022 Nelson Rd
Bend, OR 97701-9790

Call (541) 318-1676 Map

Mailing address

5500 Ming Ave Ste 410
Bakersfield, CA 93309-4631

Other practice locations

63140 Dickey Rd, Bend, OR 97701-9742 · (541) 318-1676

Specialties and licenses

Taxonomy	Code	License
Emotionally Disturbed Childrens' Residential Treatment Facility Primary	322D00000X	None listed

Emotionally Disturbed Childrens' Residential Treatment Facility: 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.

3 other providers at this address

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NPI record

NPI: 1194437004
Entity type: Organization (Type 2)
Issued: Dec 22, 2022
Last updated: Apr 28, 2026
Status: Active
Subpart: Yes of Change Academy at Lake of the Ozarks

Other names

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Embark Behavioral Health · doing business as

Authorized official

Sharnell Spencer
Credentialing Manager
(661) 239-6923

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1194437004

Change Academy at Lake of the Ozarks's National Provider Identifier is 1194437004, issued on Dec 22, 2022. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Bend, OR. The record was last updated on Apr 28, 2026.