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Organization
GRAND LAKE MENTAL HEALTH CENTER, INC.
Active
Organization
GRAND LAKE MENTAL HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DANLEY (CEO)
(918) 273-1841
Entity
Organization
Contact information
Practice address
1323 W KEETOOWAH ST, TAHLEQUAH, OK 74464-3462
(918) 708-3006
(918) 777-9016
Mailing address
114 W DELAWARE AVE, NOWATA, OK 74048-2601
(918) 273-1841
(918) 273-1843
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/27/2015
Last updated
01/16/2018
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