Grand Lake Mental Health Center, Inc.

NPI #1598216087 in Grove, Oklahoma

Provider Information

NPI Number: 1598216087
Entity Type: Organization
Organization Name: Grand Lake Mental Health Center, Inc.
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Oct 19, 2016
Last Updated: Oct 19, 2016

Practice Location

Address: 1010 HARBER RD
City: Grove
State: Oklahoma
ZIP Code: 74344-5147
Phone: (918) 786-4434

Authorized Official

Name: CHARLES DANLEY
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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Jimmy Selanders JR.	Clinic/Center - Mental Health (Including Community Mental Health Center)	Grove	AI Deep Dive

Organizations

Provider Name	Specialty	City
Grand Lake Mental Health Center, Inc.	Clinic/Center - Mental Health (Including Community Mental Health Center)	Grove	AI Deep Dive
Grand Lake Mental Health Center INC	Clinic/Center - Mental Health (Including Community Mental Health Center)	Grove	AI Deep Dive
Grand Lake Mental Health Center, Inc.	Clinic/Center - Mental Health (Including Community Mental Health Center)	Grove	AI Deep Dive
Grand Lake Mental Health Center, Inc.	Clinic/Center - Mental Health (Including Community Mental Health Center)	Grove	AI Deep Dive

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