Organization
GRAND LAKE MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS AUSTIN (RSS)
(918) 791-5453
Entity
Organization
Contact information
Practice address
111 S TREATY RD, MIAMI, OK 74354-5327
(918) 418-3062
Mailing address
111 S TREATY RD, MIAMI, OK 74354-5327
(918) 418-3062
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
12/20/2019
Last updated
01/23/2020
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