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 1851931794. The provider is registered as an organization entity type.
The provider's business location address is:
110 N 4TH ST
PONCA CITY, OK
ZIP 74601-527
Phone: (580) 749-5056
Fax: (580) 215-5765
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 CLIA number assigned to this NPI record is 37D2173487 - other - ccbhc with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 1/8/2020 and was last updated on 1/8/2020.