GRAND LAKE MENTAL HEALTH CENTER INC. (NPI# 1295084531) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295084531 |
| Entity Type | Organization |
| Organization Name | GRAND LAKE MENTAL HEALTH CENTER INC. |
| Other Organization Name | GRAND LAKE MEDICAL HEALTH CENTER |
| Practice Address |
211 N Highway 10 Ste A Kansas OK 74347-7076 |
| Mailing Address |
114 W Delaware Ave Nowata OK 74048-2601 |
| Practice Telephone | 9187864434 |
| Practice Fax Number | 9187864435 |
| Mailing Telephone | 9187864434 |
| Mailing Fax Number | 9187864435 |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2020-09-03 |
| Authorized Official Name | LARRY SMITH (CEO) |
| Authorized Official Telephone | 9182731841 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100732860L | 05 |
| Other Name | Type Code |
|---|---|
| Grand Lake Medical Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679983696 | Grand Lake Mental Health Center Inc. | Clinic/Center | 405 E Excelsior Ave, Vinita, OK 74301-4226 | 2014-04-29 |
| 1841600863 | Grand Lake Mental Health Center Inc. | Clinic/Center | 138 S Main, Afton, OK 74331-1822 | 2014-04-29 |
| 1477851756 | Grand Lake Mental Health Center Inc. | Clinic/Center | 325 S Ash St, Nowata, OK 74048-4628 | 2011-03-10 |
| Street Address |
211 N HIGHWAY 10 STE A |
| City | KANSAS |
| State | OK |
| Zip Code | 74347-7076 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801313564 | Discover Well-beings, Pllc | Family Medicine | Crossroads Wellness Center, 1107 E Carlton Ln, Kansas, OK 74347 | 2017-08-24 |
| 1528428810 | Katherine Singleton | Counselor | 207 N. Highway 59 Suite 1, Kansas, OK 74347 | 2016-02-29 |
| 1669843181 | Sonya Furgerson | Local Education Agency (LEA) | 207 W Main, Kansas, OK 74347 | 2015-10-09 |
| 1649641184 | Shelly Tennison | Local Education Agency (LEA) | 207 W. Main, Kansas, OK 74347 | 2015-10-09 |
| 1285299008 | Catherine Shanon Maddan | Case Manager/Care Coordinator | 207 N Highway 59, Kansas, OK 74347 | 2019-05-07 |
| 1003287525 | Mary Oakball | Local Education Agency (LEA) | 207 W Main, Kansas, OK 74347 | 2015-10-09 |
| 1497136766 | Deanne Hutchinson | Case Manager/Care Coordinator | 207 N. Highway 59, Kansas, OK 74347 | 2015-06-12 |
| 1932749876 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 211 N Hwy 10 Ste D, Kansas, OK 74347-0000 | 2020-01-08 |
| 1184177842 | Melissa Rowe | Case Manager/Care Coordinator | 207 N. Hwy. 59, Kansas, OK 74347-0000 | 2016-07-29 |
| 1679927552 | Theresa-grace Gibbins | Case Manager/Care Coordinator | 207 N Hwy 59, Kansas, OK 74347-0000 | 2016-04-18 |
| Find all providers in zip 74347 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932749876 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 211 N Hwy 10 Ste D, Kansas, OK 74347-0000 | 2020-01-08 |
| 1114458858 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 211 N. Hwy 59 Ste A and B, Kansas, OK 74347-7607 | 2017-03-24 |
| 1457991390 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 207 N Hwy 59, Kansas, OK 74347-0000 | 2020-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870742 | Sequelcare of Oklahoma, LLC | Clinic/Center | 6218 S Lewis Ave Ste 118, Tulsa, OK 74136-1018 | 2020-10-28 |
| 1649870890 | M & M Counseling Group, LLC | Clinic/Center | 207 S Czech Hall Rd, Yukon, OK 73099-6851 | 2020-10-27 |
| 1992303721 | Misty Watkins | Clinic/Center | 1601 Sw Parkridge Blvd Ste 200, Lawton, OK 73505-7564 | 2020-10-14 |
| 1295342046 | Integrative Healthcare Solutions LLC | Clinic/Center | 2227 E 8th St, Tulsa, OK 74104-3237 | 2020-09-25 |
| 1235744020 | Strength of A Warrior Counseling Services LLC | Clinic/Center | 4516 Se 25th St, Del City, OK 73115-4114 | 2020-09-09 |
| 1609488253 | Alexie Foster, LLC | Clinic/Center | 16802 S 301st West Ave, Bristow, OK 74010-2265 | 2020-08-17 |
| 1306455068 | Restore Family Counseling, LLC | Clinic/Center | 100 W. Wilshire, Suite #c3, Oklahoma City, OK 73116 | 2020-07-29 |
| 1245855857 | Dragonfly Psychotherapy | Clinic/Center | 2942 Ne Orlie Dr, Forest Park, OK 73121-2436 | 2020-06-09 |
| 1508480872 | Maria Nancy Martinez | Clinic/Center | 5350 S Western Ave Ste 217, Oklahoma City, OK 73109-4525 | 2020-06-03 |
| 1649894015 | Miranda Rackers | Clinic/Center | 1308 E Mckinley Ave, Sapulpa, OK 74066-4824 | 2020-06-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.