# GRAND LAKE HEALTH CARE, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619459708
- **Authorized official:** MR. JOSEPH JAMES GELINAS NP (OWNER/PROVIDER)
- **Authorized official phone:** (918) 787-3491

## Contact information

- **Practice address:** 601 S BROADWAY ST, GROVE, OK 74344-3429
- **Practice address phone:** (918) 801-6085
- **Mailing address:** 62500 E 247 LOOP, GROVE, OK 74344-7435
- **Mailing address phone:** (918) 787-5240

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 80573 | OK | Yes |

## Other

- **Enumeration date:** 09/05/2018
- **Last updated:** 02/25/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 20313460A | — | OK |