GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI# 1912531344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912531344 |
| Entity Type | Organization |
| Organization Name | GRAND LAKE MENTAL HEALTH CENTER, INC. |
| Other Organization Name | GRAND LAKE MEDICAL HEALTH CENTER |
| Practice Address |
3186 W Highway 412 West Siloam Springs OK 74338-1356 |
| Mailing Address |
114 W Delaware Ave Nowata OK 74048-2601 |
| Practice Telephone | 9187864434 |
| Mailing Telephone | 9182731841 |
| Mailing Fax Number | 9182731843 |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-03-17 |
| Authorized Official Name | LARRY SMITH (CEO) |
| Authorized Official Telephone | 9182731841 |
| Is Organization Subpart | N |
| 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 Name | Type Code |
|---|---|
| Grand Lake Medical Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1306854245 | Grand Lake Mental Health Center, Inc. | Case Management | 120 S Treaty Rd, Miami, OK 74354-5326 | 2006-08-04 |
| Street Address |
3186 W HIGHWAY 412 |
| City | WEST SILOAM SPRINGS |
| State | OK |
| Zip Code | 74338-1356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750945903 | Jennifer L Mitchell | Registered Nurse | 644 State Line Rd, Colcord, OK 74338 | 2019-04-23 |
| 1780739011 | Colcord Public Schools | Local Education Agency (LEA) | 433 South Larmon St, Colcord, OK 74338 | 2007-01-25 |
| 1396841094 | Quail Ridge Living Center Inc | Skilled Nursing Facility | 564 State Line Rd, Colcord, OK 74338 | 2006-09-16 |
| 1457839490 | Michele Tobey | Nurse Practitioner | 2230 Highway 412, Colcord, OK 74338-1308 | 2018-08-01 |
| 1417248246 | Sequoyah Living Centers, Inc. | Assisted Living Facility | 434 Stateline Rd, Colcord, OK 74338-1340 | 2011-04-27 |
| 1508893546 | John Douglas Smiley | Chiropractor | 768 Stateline Rd, Colcord, OK 74338-1346 | 2006-06-26 |
| 1164857025 | A Voice for Children | Community/Behavioral Health | 802 Stateline Rd, Colcord, OK 74338-1348 | 2013-09-11 |
| 1811293699 | Deborah J Harris | Counselor | 820 Stateline Rd Ste B, Colcord, OK 74338-1348 | 2011-01-27 |
| 1124065479 | Susan A Vaughan | Optometrist | 820 Stateline Rd, Colcord, OK 74338-1348 | 2006-06-02 |
| 1982978623 | New Creation Counseling Center | Community/Behavioral Health | 820 Stateline Rd Ste B, Colcord, OK 74338-1348 | 2012-02-27 |
| Find all providers in zip 74338 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205466372 | Grand Lake Mental Health Center, Inc | Clinic/Center | 3186 W Hwy 412, West Siloam Springs, OK 74338-1356 | 2020-01-17 |
| 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 | ||||
| City | WEST SILOAM SPRINGS |
| Zip Code | 74338 |
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| 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.