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
1228 PECAN, PAWHUSKA, OK 74056-5928
(918) 604-6054
(918) 777-9018
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
10/17/2019
Last updated
10/31/2022
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