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GRAND LAKE MENTAL HEALTH CENTER INC. NPI 1306394788


NPI Information

NPI: 1306394788
Provider Name: GRAND LAKE MENTAL HEALTH CENTER, INC.

Doing Business As: GRAND LAKE MEDICAL HEALTH CENTER

Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
110 N 4TH ST
PONCA CITY, OK
ZIP 74601
Phone: (918) 273-1841
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GRAND LAKE MENTAL HEALTH CENTER, INC. is a mental health (including community mental health center) clinic center in Ponca City, OK. GRAND LAKE MENTAL HEALTH CENTER, INC. NPI is 1306394788. The provider is registered as an organization entity type.
The provider Is Doing Business As Grand Lake Medical Health Center.

The provider's business location address is:

110 N 4TH ST
PONCA CITY, OK
ZIP 74601-527
Phone: (918) 273-1841
Fax: (918) 273-1843

The provider's authorized official is Larry Smith .
The authorized official title is Ceo and has the following contact phone number (918) 273-1841.

The enumeration date for this NPI number is 9/14/2016 and was last updated on 7/31/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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