NPI age
3 years
Enumerated 2022-08-16
● Active Type 2 · Organization
Subpart
Change Academy At Lake Of The Ozarks
Change Academy At Lake Of The Ozarks is 1 of 1335 clinic/center organizations in Texas.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Spencer
Credentialing Manager
Last NPPES update
2025-05-14
Source: monthly bulk 2026-05
How this organization compares
Across 1335 active clinic/center providers in Texas.
NPI age
3 years
≈ at median (3 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2022 → 2026
2022-08Enumerated in NPPES
2022
2026
Where they practice
Primary practice location
4800 Sugar Grove Blvd Ste 275
Stafford, TX 774772150
Mailing address
5500 Ming Ave Ste 410
Bakersfield, CA 933094631
Authorized official
Sharnell Spencer
Credentialing Manager
📞 6612396923
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Injila Imam Counselor NPI 1760100994
Specialties
-
Clinic/Center PrimaryDefinition to come...
Other names on file (2)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Embark Virtual at Texas
-
Embark Virtual at Texas
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
Subpart of Change Academy At Lake Of The Ozarks.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.