Grand Lake Mental Health Center, Inc. | |
124 E 6th St Pawhuska OK 74056-4204 | |
(918) 604-6054 | |
(918) 777-9018 |
Full Name | Grand Lake Mental Health Center, Inc. |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 124 E 6th St, Pawhuska, 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 |
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Grand Lake Mental Health Center, Inc. 114 W Delaware Ave Nowata OK 74048-2601 Ph: (918) 273-1841 | Grand Lake Mental Health Center, Inc. 124 E 6th St Pawhuska OK 74056-4204 Ph: (918) 604-6054 |
NPI Number | 1477134211 |
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Provider Enumeration Date | 04/14/2021 |
Last Update Date | 04/14/2021 |
Certification Date | 03/23/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1477134211 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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