Grand Lake Mental Health Center, Inc.

NPI #1659952497 in Cleveland, Oklahoma

Provider Information

NPI Number: 1659952497
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 14, 2021
Last Updated: Apr 14, 2021

Practice Location

Address: 907 W CADDO ST
City: Cleveland
State: Oklahoma
ZIP Code: 74020-4201
Phone: (918) 308-5511

Authorized Official

Name: 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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Grand Lake Mental Health Center, Inc.	Clinic/Center - Mental Health (Including Community Mental Health Center)	Cleveland	AI Deep Dive
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