| Grand Mental Health | |
|
109 N Fairland St Pryor OK 74361-4203 | |
| (918) 825-1405 | |
| (918) 825-1406 |
| Full Name | Grand Mental Health |
|---|---|
| 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 Mental Health 114 W Delaware Ave Nowata OK 74048-2601 Ph: (918) 273-1841 | Grand Mental Health 109 N Fairland St Pryor OK 74361-4203 Ph: (918) 825-1405 |
| NPI Number | 1336788652 |
|---|---|
| Provider Enumeration Date | 01/03/2020 |
| Last Update Date | 06/13/2022 |
| Certification Date | 06/13/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336788652 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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