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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