GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI# 1316955198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316955198 |
| Entity Type | Organization |
| Organization Name | GRAND LAKE MENTAL HEALTH CENTER, INC. |
| Other Organization Name | GRAND LAKE MEDICAL HEALTH CENTER |
| Practice Address |
17599 S Highway 88 Claremore OK 74017-0801 |
| Mailing Address |
114 W Delaware Ave Nowata OK 74048-2601 |
| Practice Telephone | 9182731841 |
| Practice Fax Number | 9182731843 |
| Mailing Telephone | 9182731841 |
| Mailing Fax Number | 9182731841 |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-07-31 |
| 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 | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100732860C | 05 |
| Other Name | Type Code |
|---|---|
| Grand Lake Medical Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912531344 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 3186 W Highway 412, West Siloam Springs, OK 74338-1356 | 2020-02-25 |
| 1760022602 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1010 Harbor Rd, Grove, OK 74344-5147 | 2020-01-08 |
| 1932749876 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 211 N Hwy 10 Ste D, Kansas, OK 74347-0000 | 2020-01-08 |
| 1487201133 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 7307 S Yale Ave, Suite 101, Tulsa, OK 74136-7134 | 2019-08-19 |
| 1114458858 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 211 N. Hwy 59 Ste A and B, Kansas, OK 74347-7607 | 2017-03-24 |
| 1598216087 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1010 Harber Rd, Grove, OK 74344-5147 | 2016-10-19 |
| 1003292061 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 1370 Se Washington Blvd, Bartlesville, OK 74006-4519 | 2015-07-31 |
| 1114269917 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 9432 N. May Ave, Suite D, Oklahoma City, OK 73120-2723 | 2013-03-20 |
| 1104167204 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 9430 N May Ave, Oklahoma City, OK 73120-2712 | 2013-03-14 |
| 1922017060 | Grand Lake Mental Health Center, Inc. | Case Management | 513 S Quapaw Ave, Bartlesville, OK 74003-4331 | 2006-08-07 |
| Street Address |
17599 S HIGHWAY 88 |
| City | CLAREMORE |
| State | OK |
| Zip Code | 74017-0801 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073520102 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 17599 S Highway 88, Claremore, OK 74017-0801 | 2006-08-02 |
| 1194365031 | Grand Lake Mental Health Center, Inc. | Clinic/Center | 17599 S Highway 88, Claremore, OK 74017-0801 | 2020-01-08 |
| 1396387403 | Jessica Depoe | Case Manager/Care Coordinator | 17599 S Highway 88, Claremore, OK 74017-0801 | 2019-10-09 |
| 1053810838 | Lauren Nicole Bahle | Nutritionist | 17599 S Highway 88, Claremore, OK 74017-0801 | 2018-02-07 |
| 1932617776 | Andrew Hooks | Nutritionist | 17599 S Highway 88, Claremore, OK 74017-0801 | 2018-01-15 |
| 1588171656 | Jeff Dutton | Peer Specialist | 17599 S Highway 88, Claremore, OK 74017-0801 | 2018-01-10 |
| 1003330747 | Virginia Elizabeth Geary | Case Manager/Care Coordinator | 17599 S Highway 88, Claremore, OK 74017-0801 | 2017-08-02 |
| 1497276810 | Mikayla Marie Navarro | Case Manager/Care Coordinator | 17599 S Highway 88, Claremore, OK 74017-0801 | 2017-07-06 |
| 1598206807 | Angellica Bains | Case Manager/Care Coordinator | 17599 S Highway 88, Claremore, OK 74017-0801 | 2017-03-20 |
| 1699217091 | Larry Smith | Peer Specialist | 17599 S Highway 88, Claremore, OK 74017-0801 | 2016-11-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336763127 | Randye Knott | Physical Therapist | 99224 S. Brady St. Suite 109, Claremore, OK 74017 | 2020-06-08 |
| 1538794854 | Katie Ann Osburn | Peer Specialist | 12005 E 490 Rd, Claremore, OK 74017 | 2020-03-06 |
| 1174185144 | Jamie Lynn Bell | Dentist | 1222 N. Florence Ave, Claremore, OK 74017 | 2019-07-01 |
| 1508326877 | Cheri L Doyle | Social Worker | Foundation Behavioral Health, 1218 N Florence Ave Suite 1218b, Claremore, OK 74017 | 2019-03-22 |
| 1487144374 | Kimberly Gale Henry | Case Manager/Care Coordinator | 16305 E Grand Meadow Dr., Claremore, OK 74017 | 2018-05-16 |
| 1912449836 | Katie Jentry Greenwell | Case Manager/Care Coordinator | 423 N. Seminole, Claremore, OK 74017 | 2016-11-09 |
| 1598219347 | Spring Dental Claremore | Dentist | 504 S. Lynn Riggs Blvd., Ste #100, Claremore, OK 74017 | 2016-08-10 |
| 1811366701 | Alonna Adair-triplett | Registered Nurse | 101 S. Moore, Claremore, OK 74017 | 2015-09-21 |
| 1992135719 | Jordan Nicole Martin | Behavioral Analyst | 24797 Oklahoma 66, Claremore, OK 74017 | 2013-11-14 |
| 1992059398 | Wood Manor, Inc. | Alzheimer Center (Dementia Center) | 2800 N. Hickory, Claremore, OK 74017 | 2012-11-07 |
| Find all providers in zip 74017 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356667356 | Osu Center for Health Sciences | Clinic/Center | 1715 N Lynn Riggs Blvd, Suite 2, Claremore, OK 74017-3056 | 2010-04-15 |
| 1093979031 | Osu Center for Health Sciences | Clinic/Center | 2990 N Sioux Ave, Claremore, OK 74017-3700 | 2008-07-17 |
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|---|---|---|---|---|
| 1093312548 | Prime Health Associates, Pllc | Clinic/Center | 2511 Alexa Ave, Edmond, OK 73034-3458 | 2020-10-07 |
| 1598387524 | Thomas E. Cashero Md LLC | Clinic/Center | 90 N 30th St Ste 5, Clinton, OK 73601-3100 | 2020-05-13 |
| 1184271793 | Healthy Skin Dermatology of Oklahoma Pllc | Clinic/Center | 13933 Technology Dr Ste B, Oklahoma City, OK 73134-1053 | 2019-08-20 |
| 1922572809 | Endovascular Consulting Solutions | Clinic/Center | 1705 E 19th St Ste 410, Tulsa, OK 74104-5415 | 2019-01-14 |
| 1831610641 | Scot A Sullivan Md PC | Clinic/Center | 2020 E 15th St Ste B, Edmond, OK 73013-6749 | 2017-06-30 |
| 1053862102 | Okc Neurology-catherine E Porter Md, Pllc | Clinic/Center | 6701 W Hefner Rd Ste B, Oklahoma City, OK 73162-4706 | 2016-10-24 |
| 1730584509 | Digital Diagnostic Solutions LLC | Clinic/Center | 5017 S Frontage Road, Tulsa, OK 74107-8976 | 2014-10-23 |
| 1891102331 | Panhandle Counseling and Health Center, Inc. | Clinic/Center | 5170 Patricia Blvd, Guymon, OK 73942-0000 | 2014-07-16 |
| 1922350719 | Allergy Arts of Oklahoma Pllc | Clinic/Center | 3300 Nw 56th St Ste 100, Oklahoma City, OK 73112-4538 | 2012-10-04 |
| 1255699112 | Meghan E. Scears, Md, Pllc | Clinic/Center | 808 24th Ave Nw Ste 202, Norman, OK 73069-6204 | 2012-04-30 |
| 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.