GRAND LAKE MENTAL HEALTH CENTER, INC.


Address: 1115 Harbor Rd, Grove, OK 74344-3505
Phone: 9187864434

GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI# 1427697747) 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) 1427697747
Entity Type Organization
Organization Name GRAND LAKE MENTAL HEALTH CENTER, INC.
Practice Address 1115 Harbor Rd
Grove
OK 74344-3505
Mailing Address 114 W Delaware Ave
Nowata
OK 74048-2601
Practice Telephone 9187864434
Practice Fax Number 9187864435
Mailing Telephone 9182731841
Mailing Fax Number 9182731843
Enumeration Date 2020-01-03
Last Update Date 2020-01-03
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/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
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 1115 HARBOR RD
City GROVE
State OK
Zip Code 74344-3505

Providers in the same location

NPI Name Taxonomy Address Enumeration
1063429181 Grand Lake Mental Health Center, Inc. Clinic/Center 1115 Harbor Rd, Grove, OK 74344-3505 2006-08-02
1669084620 Deanna M Duvall Social Worker 1115 Harbor Rd, Grove, OK 74344-3505 2020-08-20
1558979831 Amber Rae Coker Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2020-07-22
1275157166 Katharine Jean Downing Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2020-06-05
1205464997 Kristen Bartz Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2020-03-30
1144853631 Jennifer Elizabeth Bowerman Peer Specialist 1115 Harbor Rd, Grove, OK 74344-3505 2020-02-13
1598302572 Shelbi Ann Brock Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2019-12-09
1447896907 Jennifer Lynne Andrews Registered Nurse 1115 Harbor Rd, Grove, OK 74344-3505 2019-11-20
1497399331 Steven Graham Shackelford Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2019-11-04
1487200887 Tyler Payton Case Manager/Care Coordinator 1115 Harbor Rd, Grove, OK 74344-3505 2019-08-13
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1326604935 Deborah Stauss Massage Therapist 2086 S Main St, Grove, OK 74344 2019-05-20
1841776705 Progressive Orthotic & Prosthetic Services, Inc Prosthetic/Orthotic Supplier 10 E 6th St., Grove, OK 74344 2018-07-13
1205329232 Andra Renee Mitchell Speech-Language Pathologist 825 E Third Street, Grove, OK 74344 2018-06-13
1861996217 Jenniffer Colleen Clark I Case Manager/Care Coordinator 1115 Har-ber Rd, Grove, OK 74344 2018-03-21
1417458167 Jason S Beckham Case Manager/Care Coordinator 32600 S. 625 Road, Grove, OK 74344 2018-02-27
1659872034 Keli Elaine Whitlock Peer Specialist 5602 Us Hwy 59, Grove, OK 74344 2018-02-22
1851899454 Nichole Marie Wooton Case Manager/Care Coordinator 1115 Har-ber Road, Grove, OK 74344 2018-01-29
1043766645 Samantha Lane Speech-Language Pathologist 1046 Hillside Road, Grove, OK 74344 2016-09-01
1376927509 Matthew Kyle Allen Physical Therapy Assistant 4621 Hwy 59 N, Grove, OK 74344 2015-07-17
1477807428 Andrew Scott Littlejohn Physical Therapy Assistant 103 Harber Road, Grove, OK 74344 2012-10-30
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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
1760022602 Grand Lake Mental Health Center, Inc. Clinic/Center 1010 Harbor Rd, Grove, OK 74344-5147 2020-01-08
1598216087 Grand Lake Mental Health Center, Inc. Clinic/Center 1010 Harber Rd, Grove, OK 74344-5147 2016-10-19
1295145217 Grand Lake Mental Health Center Inc Clinic/Center 1115 S Harber Rd, Grove, OK 74344-7918 2014-04-29
1063429181 Grand Lake Mental Health Center, Inc. Clinic/Center 1115 Harbor Rd, Grove, OK 74344-3505 2006-08-02
1265821102 Jimmy Selanders Jr. Clinic/Center 32300 S 625 Rd, Grove, OK 74344-6285 2015-01-15

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 GROVE
Zip Code 74344

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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