| Grand Lake Medical Health Center | |
|
109 N Fairland St Pryor OK 74361-4203 | |
| (918) 825-1405 | |
| Not Available |
| Full Name | Grand Lake Medical Health Center |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 109 N Fairland St, Pryor, 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 Medical Health Center 114 W Delaware Ave Nowata OK 74048-2601 Ph: () - | Grand Lake Medical Health Center 109 N Fairland St Pryor OK 74361-4203 Ph: (918) 825-1405 |
| NPI Number | 1063817021 |
|---|---|
| Provider Enumeration Date | 11/03/2014 |
| Last Update Date | 07/31/2020 |
| Certification Date | 07/31/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063817021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Grand Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 109 N Fairland St, Pryor, OK 74361 Phone: 918-825-1405 Fax: 918-825-1406 | |
People Inc. Of Sequoyah Co Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 32 S Adair St, Pryor, OK 74361 Phone: 918-775-7787 Fax: 918-775-4382 | |
Pushmataha Counseling Services, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 205 S Adair St, Pryor, OK 74361 Phone: 918-825-4872 | |
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