| Change Academy At Lake Of The Ozarks | |
|
5000 Birch St Ste 1400 Newport Beach CA 92660-2150 | |
| (949) 688-6282 | |
| Not Available |
| Full Name | Change Academy At Lake Of The Ozarks |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5000 Birch St Ste 1400, Newport Beach, California |
| Authorized Official Name and Position | Sharnell Spencer (CREDENTIALING MANAGER) |
| Authorized Official Contact | 6612396923 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Change Academy At Lake Of The Ozarks 5500 Ming Ave Ste 410 Bakersfield CA 93309-4631 Ph: (661) 622-4132 | Change Academy At Lake Of The Ozarks 5000 Birch St Ste 1400 Newport Beach CA 92660-2150 Ph: (949) 688-6282 |
| NPI Number | 1811601784 |
|---|---|
| Provider Enumeration Date | 01/05/2023 |
| Last Update Date | 05/21/2025 |
| Certification Date | 05/21/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811601784 | NPI | - | NPPES |
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