GRAND LAKE MENTAL HEALTH CENTER INC. NPI 1407228752

NPI Information

NPI: 1407228752
Provider Name: GRAND LAKE MENTAL HEALTH CENTER, INC.
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
1323 W KEETOOWAH ST
TAHLEQUAH, OK
ZIP 74464
Phone: (918) 708-3006
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GRAND LAKE MENTAL HEALTH CENTER, INC. is a mental health (including community mental health center) clinic center in Tahlequah, OK. GRAND LAKE MENTAL HEALTH CENTER, INC. NPI is 1407228752. The provider is registered as an organization entity type.

The provider's business location address is:

1323 W KEETOOWAH ST
TAHLEQUAH, OK
ZIP 74464-462
Phone: (918) 708-3006
Fax: (918) 777-9016

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

The enumeration date for this NPI number is 10/27/2015 and was last updated on 1/16/2018.

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
1	261QM0801X	Clinic/Center	Mental 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

NPI Synchronization or Removal

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