| Grand Lake Mental Health Center, Inc. | |
|
6128 E 38th St Tulsa OK 74135-5832 | |
| (918) 664-4224 | |
| (918) 663-0203 |
| Full Name | Grand Lake Mental Health Center, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 6128 E 38th St, Tulsa, 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. 6128 E 38th St Tulsa OK 74135-5832 Ph: (918) 664-4224 | Grand Lake Mental Health Center, Inc. 6128 E 38th St Tulsa OK 74135-5832 Ph: (918) 664-4224 |
| NPI Number | 1659072395 |
|---|---|
| Provider Enumeration Date | 03/10/2023 |
| Last Update Date | 03/10/2023 |
| Certification Date | 03/08/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659072395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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