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Organization
GRAND LAKE MENTAL HEALTH CENTER, INC.
Active
Organization
GRAND LAKE MENTAL HEALTH CENTER, INC.
Active
Other names
Grand Lake Mental Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DANLEY (CEO)
(918) 273-1841
Entity
Organization
Contact information
Practice address
110 N 4TH ST, PONCA CITY, OK 74601-4527
(580) 749-5056
(580) 215-5765
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
01/08/2020
Last updated
01/08/2020
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