Grand Lake Mental Health Center INC

NPI #1689206922 in Jay, Oklahoma

Provider Information

NPI Number: 1689206922
Entity Type: Organization
Organization Name: Grand Lake Mental Health Center INC
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Feb 5, 2020
Last Updated: Feb 5, 2020

Practice Location

Address: 1015 W WASHBOURNE ST
City: Jay
State: Oklahoma
ZIP Code: 74346-4205
Phone: (918) 381-9090

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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