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Organization
GRAND LAKE MENTAL HEALTH CENTER, INC.
Active
Organization
GRAND LAKE MENTAL HEALTH CENTER, INC.
Active
Other names
GRAND Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY SMITH (CEO)
(918) 273-1841
Entity
Organization
Contact information
Practice address
17599 S HIGHWAY 88, CLAREMORE, OK 74017-0801
(918) 342-0770
Mailing address
114 W DELAWARE AVE, NOWATA, OK 74048-2601
(918) 342-9530
(918) 342-9533
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100732860J
—
OK
Enumeration date
08/02/2006
Last updated
06/07/2022
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