GRAND LAKE MENTAL HEALTH CENTER INC (NPI# 1295145217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295145217 |
| Entity Type | Organization |
| Organization Name | GRAND LAKE MENTAL HEALTH CENTER INC |
| Other Organization Name | GRAND LAKE MEDICAL HEALTH CENTER |
| Practice Address |
1115 S Harber Rd Grove OK 74344-7918 |
| Mailing Address |
114 W Delaware Ave Nowata OK 74048-2601 |
| Practice Telephone | 9187864434 |
| Mailing Telephone | 9182731841 |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2020-07-31 |
| Authorized Official Name | MR. 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 |
| Other Name | Type Code |
|---|---|
| Grand Lake Medical Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659904076 | Grand Lake Mental Health Center Inc | Clinic/Center | 4815 S Harvard Ave Ste 420, Tulsa, OK 74135-3068 | 2020-02-13 |
| 1356981138 | Grand Lake Mental Health Center Inc | Community/Behavioral Health | 2225 N Union, Ponca City, OK 74601-1536 | 2020-01-09 |
| 1588136758 | Grand Lake Mental Health Center Inc | Clinic/Center | 4815 S. Harvard, Suite 420, Tulsa, OK 74135-3068 | 2018-12-27 |
| 1043842370 | Grand Lake Mental Health Center Inc | Clinic/Center | 2225 N Union St., Ponca City, OK 74601-7460 | 2020-02-05 |
| 1689206922 | Grand Lake Mental Health Center Inc | Clinic/Center | 1015 W Washbourne St, Jay, OK 74346-4205 | 2020-02-05 |
| 1992341671 | Grand Lake Mental Health Center Inc | Clinic/Center | 1624 Cimarron Plz, Stillwater, OK 74075-3467 | 2019-11-18 |
| 1457993834 | Grand Lake Mental Health Center Inc | Clinic/Center | 124 E 6th St, Pawhuska, OK 74056-4204 | 2019-10-17 |
| 1134539141 | Grand Lake Mental Health Center Inc | Clinic/Center | 12005 E 470 Rd, Claremore, OK 74017-3737 | 2014-04-29 |
| 1588074595 | Grand Lake Mental Health Center Inc | Clinic/Center | 111 S Treaty Rd, Miami, OK 74354-5327 | 2014-04-29 |
| Street Address |
1115 S HARBER RD |
| City | GROVE |
| State | OK |
| Zip Code | 74344-7918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326604935 | Deborah Stauss | Massage Therapist | 2086 S Main St, Grove, OK 74344 | 2019-05-20 |
| 1841776705 | Progressive Orthotic & Prosthetic Services, Inc | Prosthetic/Orthotic Supplier | 10 E 6th St., Grove, OK 74344 | 2018-07-13 |
| 1205329232 | Andra Renee Mitchell | Speech-Language Pathologist | 825 E Third Street, Grove, OK 74344 | 2018-06-13 |
| 1861996217 | Jenniffer Colleen Clark I | Case Manager/Care Coordinator | 1115 Har-ber Rd, Grove, OK 74344 | 2018-03-21 |
| 1417458167 | Jason S Beckham | Case Manager/Care Coordinator | 32600 S. 625 Road, Grove, OK 74344 | 2018-02-27 |
| 1659872034 | Keli Elaine Whitlock | Peer Specialist | 5602 Us Hwy 59, Grove, OK 74344 | 2018-02-22 |
| 1851899454 | Nichole Marie Wooton | Case Manager/Care Coordinator | 1115 Har-ber Road, Grove, OK 74344 | 2018-01-29 |
| 1043766645 | Samantha Lane | Speech-Language Pathologist | 1046 Hillside Road, Grove, OK 74344 | 2016-09-01 |
| 1376927509 | Matthew Kyle Allen | Physical Therapy Assistant | 4621 Hwy 59 N, Grove, OK 74344 | 2015-07-17 |
| 1477807428 | Andrew Scott Littlejohn | Physical Therapy Assistant | 103 Harber Road, Grove, OK 74344 | 2012-10-30 |
| Find all providers in zip 74344 | ||||
| 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 |
|---|---|---|---|---|
| 1760022602 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1010 Harbor Rd, Grove, OK 74344-5147 | 2020-01-08 |
| 1598216087 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1010 Harber Rd, Grove, OK 74344-5147 | 2016-10-19 |
| 1063429181 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1115 Harbor Rd, Grove, OK 74344-3505 | 2006-08-02 |
| 1427697747 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1115 Harbor Rd, Grove, OK 74344-3505 | 2020-01-03 |
| 1265821102 | Jimmy Selanders Jr. | Clinic/Center | 32300 S 625 Rd, Grove, OK 74344-6285 | 2015-01-15 |
| 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.