| Grand Lake Mental Health Center, Inc. | |
|
325 S Ash St Nowata OK 74048-4628 | |
| (918) 273-7344 | |
| (918) 999-0111 |
| Full Name | Grand Lake Mental Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 325 S Ash St, Nowata, Oklahoma |
| Authorized Official Name and Position | Larry Smith (CEO) |
| Authorized Official Contact | 9182731841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Lake Mental Health Center, Inc. 114 W Delaware Ave Nowata OK 74048-2601 Ph: (918) 273-1841 | Grand Lake Mental Health Center, Inc. 325 S Ash St Nowata OK 74048-4628 Ph: (918) 273-7344 |
| NPI Number | 1902487747 |
|---|---|
| Provider Enumeration Date | 04/14/2021 |
| Last Update Date | 04/14/2021 |
| Certification Date | 03/23/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902487747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Grand Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 S Ash St, Nowata, OK 74048 Phone: 918-273-7344 Fax: 918-273-5991 | |
Grand Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 W Delaware Ave, Nowata, OK 74048 Phone: 918-273-1841 Fax: 918-273-1843 | |
Grand Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 325 S Ash St, Nowata, OK 74048 Phone: 918-273-7344 Fax: 918-273-5691 |