Grand Lake Mental Health Center INC

NPI #1588074595 in Miami, Oklahoma

Provider Information

NPI Number: 1588074595
Entity Type: Organization
Organization Name: Grand Lake Mental Health Center INC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Apr 29, 2014
Last Updated: Jul 31, 2020

Practice Location

Address: 111 S TREATY RD
City: Miami
State: Oklahoma
ZIP Code: 74354-5327
Phone: (918) 540-1511

Authorized Official

Name: MR. LARRY SMITH
Title: CEO
Phone: (918) 273-1841

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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