GRAND LAKE MENTAL HEALTH CENTER, INC.


Address: 26243 Highway 51, Wagoner, OK 74467-8740
Phone: 9187083006

GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI# 1689165631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689165631
Entity Type Organization
Organization Name GRAND LAKE MENTAL HEALTH CENTER, INC.
Practice Address 26243 Highway 51
Wagoner
OK 74467-8740
Mailing Address 114 W Delaware Ave
Nowata
OK 74048-2601
Practice Telephone 9187083006
Practice Fax Number 9189990109
Mailing Telephone 9182731841
Mailing Fax Number 9182731843
Enumeration Date 2018-05-25
Last Update Date 2018-05-25
Authorized Official Name CHARLES DANLEY (CEO)
Authorized Official Telephone 9182731841
Is Organization Subpart N

Taxonomy

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 Provider IDs and Locations

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

Office Location

Street Address 26243 HIGHWAY 51
City WAGONER
State OK
Zip Code 74467-8740

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750547816 Shawna Danette Martin Case Manager/Care Coordinator 26243 Highway 51, Wagoner, OK 74467-8740 2008-07-29
1871052423 Laura Darlene Patterson Case Manager/Care Coordinator 26243 Highway 51, Wagoner, OK 74467-8740 2019-03-13
1164930822 Andrea Hamlet Case Manager/Care Coordinator 26243 Highway 51, Wagoner, OK 74467 2018-01-16
1699204792 Cortez De'angelo Edwards Case Manager/Care Coordinator 26243 Highway 51, Wagoner, OK 74467-8740 2017-06-12
1487180022 Zach Pierce Case Manager/Care Coordinator 26243 Highway 51, Wagoner, OK 74467-8740 2017-05-02
1417323254 Haley Dixon Counselor 26243 Highway 51, Wagoner, OK 74467-8740 2015-08-17
1568838597 Misty Foutch Counselor 26243 Highway 51, Wagoner, OK 74467-8740 2015-08-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982251591 Alesha Lenard Behavior Technician 901 S. Harrill Ave, Wagoner, OK 74467 2019-08-20
1679030597 Lorri Dawn Pitchford Case Manager/Care Coordinator Creoks Behavioral Health Services, 109 S Harrill Ave., Wagoner, OK 74467 2019-02-27
1144769399 Elaina Murray Technician 308 Ne 2nd St., Wagoner, OK 74467 2017-02-21
1336699784 Tommye Evidson Counselor 109 Harrill Ave, Wagoner, OK 74467 2016-10-10
1518327857 Yco Tulsa, Inc Clinic/Center 1101a South Mcquarrie, Wagoner, OK 74467 2016-02-29
1396117545 Sandra Cooper Behavioral Analyst 2109 Us-69, Wagoner, OK 74467 2015-10-28
1588051486 Penny Nye Counselor 2109 S.hwy 69, Wagoner, OK 74467 2015-04-20
1376943571 Justin F Kurtz Respiratory Therapist, Certified 1200 W. Cherokee, Suite H Cardiac/pulmonary Rehab, Wagoner, OK 74467 2014-08-26
1780009969 David H Good Family Medicine 1202 W. Cherokee St, Ste E, Wagoner, OK 74467 2014-02-25
1942598875 Robin Rodriguez-higginbottom Speech-Language Pathologist 215 E Cherokee St, Wagoner, OK 74467 2011-07-12
Find all providers in zip 74467

Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1518327857 Yco Tulsa, Inc Clinic/Center 1101a South Mcquarrie, Wagoner, OK 74467 2016-02-29
1265049654 Shayla Ricchele Phillips Clinic/Center 109 S Harrill Ave, Wagoner, OK 74467-5317 2020-09-29
1255704250 Grand Lake Mental Health Center, Inc. Clinic/Center 2109 S Highway 69, Wagoner, OK 74467-9310 2015-11-12
1932523867 James Foreman Clinic/Center 118 S Main St, Wagoner, OK 74467-5221 2014-02-12

Providers in the same taxonomy and state

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

Competitor

Search similar providers

City WAGONER
Zip Code 74467

Improve Information

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Dataset Information

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.

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