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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
191 N HIGHWAY 59, KANSAS, OK 74347-7607
(918) 308-5518
(918) 999-0112
Mailing address
114 W DELAWARE AVE, NOWATA, OK 74048-2601
(918) 308-5518
(918) 999-0112
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
—
100732860L
—
OK
Enumeration date
08/31/2012
Last updated
03/07/2024
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