GRAND LAKE MENTAL HEALTH CENTER, INC.


Address: 1323 W Keetoowah St, Tahlequah, OK 74464-3462
Phone: 9187083006

GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI# 1407228752) 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) 1407228752
Entity Type Organization
Organization Name GRAND LAKE MENTAL HEALTH CENTER, INC.
Practice Address 1323 W Keetoowah St
Tahlequah
OK 74464-3462
Mailing Address 114 W Delaware Ave
Nowata
OK 74048-2601
Practice Telephone 9187083006
Practice Fax Number 9187779016
Mailing Telephone 9182731841
Mailing Fax Number 9182731843
Enumeration Date 2015-10-27
Last Update Date 2018-01-16
Authorized Official Name CHARLES DANLEY (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 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
1003292061 Grand Lake Mental Health Center, Inc. Clinic/Center 1370 Se Washington Blvd, Bartlesville, OK 74006-4519 2015-07-31
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

Office Location

Street Address 1323 W KEETOOWAH ST
City TAHLEQUAH
State OK
Zip Code 74464-3462

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295920734 Loftin Family Practice Clinic/Center 1323 W Keetoowah St, Tahlequah, OK 74464-3462 2007-09-07
1326516022 Rachel Elizabeth Clinton Case Manager/Care Coordinator 1323 W Keetoowah St, Tahlequah, OK 74464-3462 2018-11-12
1720560261 Michelle Renee Shade Case Manager/Care Coordinator 1323 W Keetoowah St, Tahlequah, OK 74464-3462 2018-08-31
1548759327 Holly Caddell Counselor 1323 W Keetoowah St, Tahlequah, OK 74464-3462 2018-05-07
1952804106 Kristina Stricker Case Manager/Care Coordinator 1323 W Keetoowah St, Tahlequah, OK 74464-3462 2018-03-14
1326558008 Stephanie Jolene Whipple Case Manager/Care Coordinator 1323 W Keetoowah St, Tahlequah, OK 74464-3462 2017-10-06
1740623537 Jennifer A Baker Marriage & Family Therapist 1323 W Keetoowah St, Tahlequah, OK 74464-3462 2013-04-10
1629302674 Brett Hiseley Counselor 1323 W Keetoowah St, Tahlequah, OK 74464-3462 2009-09-23
1881835544 Kevin W. Perry Counselor 1323 W Keetoowah St, Tahlequah, OK 74464-3462 2009-03-10

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1184253403 Kendall Harris Student in an Organized Health Care Education/Training Program 100 Bliss Ave, Tahlequah, OK 74464 2020-04-07
1528609302 Norma Brightly Technician 103 Sequoyah, Tahlequah, OK 74464 2019-10-03
1073175832 Jody Lynn Dallis Case Manager/Care Coordinator Tenkiller Behavioral Services, 27753 S. Welling Rd, Welling, OK 74464 2019-07-02
1184287849 Perry Jake Proctor Student in an Organized Health Care Education/Training Program 1400 E Downing St, Tahlequah, Ok 74464, Tahlequah, OK 74464 2019-04-18
1336657279 Sidney Sheyenne Kimble Case Manager/Care Coordinator 1429 Jack Brown Lane, Tahlequah, OK 74464 2018-01-12
1891225686 Nichols Bradley Alberty Orthotist 1294 East Downing, Suite 3, Tahlequah, OK 74464 2017-06-14
1922549690 Krystal Easter Ms, Lpc Counselor 2201 Oakridge Dr, Tahlequah, OK 74464 2017-03-15
1144777319 Northeastern Oklahoma Community Health Centers, Inc. Clinic/Center 529 N. Oak St., Tahlequah, OK 74464 2016-09-06
1548713456 Clement Isioma Nwadozi Optometrist 3763 Southridge Cir Apt 6, Tahlequah, OK 74464 2016-07-27
1033532635 Wesley Gragg Specialist/Technologist 603 North Grand Avenue, Tahlequah, OK 74464 2014-02-03
Find all providers in zip 74464

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
1508987959 State of Oklahoma; Dba:bill Willis Community Mental Health Center Clinic/Center 1400 S. Hensley Dr, Tahlequah, OK 74465-0558 2007-04-03
1235295130 People Inc. of Sequoyah Co Clinic/Center 1606 E Downing St, Tahlequah, OK 74464-2513 2006-12-28

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
Find all providers with the same taxonomy

Competitor

Search similar providers

City TAHLEQUAH
Zip Code 74464

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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