GRAND LAKE MENTAL HEALTH CENTER, INC.


Address: 1370 Se Washington Blvd, Bartlesville, OK 74006-4519
Phone: 9183378080

GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI# 1003292061) 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) 1003292061
Entity Type Organization
Organization Name GRAND LAKE MENTAL HEALTH CENTER, INC.
Other Organization Name GRAND LAKE MEDICAL HEALTH CENTER
Practice Address 1370 Se Washington Blvd
Bartlesville
OK 74006-4519
Practice Telephone 9183378080
Enumeration Date 2015-07-31
Last Update Date 2020-07-31
Authorized Official Name LARRY SMITH (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/Organization Names

Other Name Type Code
Grand Lake Medical Health Center Doing Business As Name - Organization

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
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
1306854245 Grand Lake Mental Health Center, Inc. Case Management 120 S Treaty Rd, Miami, OK 74354-5326 2006-08-04

Office Location

Street Address 1370 SE WASHINGTON BLVD
City BARTLESVILLE
State OK
Zip Code 74006-4519

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235753930 Kameron Noelle Meyer Case Manager/Care Coordinator 1370 Se Washington Blvd, Bartlesville, OK 74006-4519 2020-05-29
1336776673 Bionca M Chambers Case Manager/Care Coordinator 1370 Se Washington Blvd, Bartlesville, OK 74006-4519 2020-03-26
1033759972 Grand Lake Mental Health Center, Inc. Clinic/Center 1370 Se Washington Blvd, Bartlesville, OK 74006-4519 2020-01-08

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1124646252 Ntcob LLC Family Medicine 234 Se De Bell Ave, Bartlesville, OK 74006 2020-07-06
1053936815 Priscella Ann Caron Nurse Practitioner 226 Se De Bell Ave Building B, Bartlesville, OK 74006 2020-06-08
1508390840 Megan Christopher Student in an Organized Health Care Education/Training Program 3400 Se Frank Phillips Blvd, Suite 502, Bartlesville, OK 74006 2017-04-13
1518339811 Dori Raycob Registered Nurse 3400 Se Frank Phillips Blvd Suite 300, Bartlesville, OK 74006 2015-10-26
1023487436 Katherine Marie Anderson Nurse Practitioner 3500 Sw Frank Phillips, Bartlesville, OK 74006 2015-09-16
1033593207 Quanisha Roberson Clinical Nurse Specialist 226 Se De Bell Avenue, Building A, Suite 101, Bartlesville, OK 74006 2015-07-16
1588064604 Vance Wayne Blackwell Jr. Counselor 2200 Se Washinton Blvd., Bartlesville, OK 74006 2014-08-26
1619314937 Scott Ethan Sonico Dentist 1224 Se Washington Blvd, Bartlesville, OK 74006 2013-05-28
1417229485 Vernon Lee Newby Veterinarian 817 Madison Blvd., Bartlesville, OK 74006 2012-02-06
1306083720 Sherry M Wilson Counselor 3925-g Frank Phillips Blvd., Bartlesville, OK 74006 2009-01-08
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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
1700326816 Preferred Family Healthcare, Inc. Clinic/Center 2114 Se Washington Blvd, Bartlesville, OK 74006-7254 2017-03-08
1902813033 Grand Lake Mental Health Center, Inc. Clinic/Center 700 S Penn Ave, Bartlesville, OK 74003-3847 2006-08-02
1033759972 Grand Lake Mental Health Center, Inc. Clinic/Center 1370 Se Washington Blvd, Bartlesville, OK 74006-4519 2020-01-08
1386284222 Grand Lake Mental Health Center, Inc. Clinic/Center 700 Sw Penn Ave, Bartlesville, OK 74003-3847 2020-01-08
1235534355 Grand Lake Mental Health Center, Inc. Clinic/Center 700 Sw Penn Ave, Bartlesville, OK 74003-3847 2014-10-31

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
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Competitor

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City BARTLESVILLE
Zip Code 74006

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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