Change Academy Lake Of The Ozarks

NPI 1134475635 - Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X

NPI Details
NPI 1134475635
Enumeration Date 08/02/2012
Last Updated 08/02/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name MICHAEL MICHAEL
Position RECREATION THERAPY DIRECTOR
Phone (573) 200-1605
Fax
Practice Location
130 CALO LN
LAKE OZARK MO, 65049-9208, US
Phone (573) 200-1605
Fax
Business Location
130 CALO LN
LAKE OZARK MO, 65049-9208, US
Phone (573) 200-1605
Fax
Toxanomy
Taxonomy Code 322D00000X
License State
License Number
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According to our database, Change Academy Lake Of The Ozarks NPI is 1134475635, taxonomy code is 322D00000X Change Academy Lake Of The Ozarks physically located at 130 Calo Ln, Lake Ozark MO, 65049-9208. NPI Number 1033115704 has the healthcare provider type.

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1134475635 NPI number is provided on an as is basis without warranty of any kind. 1134475635 is maintained by the National Plan & Provider Enumeration System. The contents of Change Academy Lake Of The Ozarks are for informational purposes only.