institution
Grand Lake Mental Health Center, Inc.
Mental Health Clinic/Center (Including Community Mental Health Center) in Vinita, Oklahoma
NPI 1710994835

Grand Lake Mental Health Center, Inc. is a Mental Health Clinic/Center (Including Community Mental Health Center) based in Nowata, OK and is specialized in Mental Health (Including Community Mental Health Center). Grand Lake Mental Health Center, Inc. practices in Vinita, OK. The NPI Number for Grand Lake Mental Health Center, Inc. is 1710994835 and holds a License No. (Oklahoma).

The current practice location address for Grand Lake Mental Health Center, Inc. is 405 E Excelsior Ave, Vinita, OK and can be reached out via phone at 918-256-6476 and via fax at 918-256-3628. You can also correspond with Grand Lake Mental Health Center, Inc. through the mailing address at 114 W DELAWARE AVE, NOWATA, OK - 74048-2601 (mailing address contact number: 918-256-6476).

Location: 405 E Excelsior Ave, Vinita, OK, 74048-2601
institution
Provider Profile Details
NPI Number
1710994835
Provider Name
Grand Lake Mental Health Center, Inc.
Credential
Provider Entity Type
Organization
Address
405 E Excelsior Ave, Vinita, OK, 74048-2601
Phone Number
918-256-6476
Fax Number
918-256-3628
Provider Enumeration Date
08/02/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
100732860F 05 OK
institution
Provider Business Practice Location Address Details
Address
405 E Excelsior Ave
City
State
Zip
74301-4226
Phone Number
918-256-6476
Fax Number
918-256-3628
person
Provider Business Mailing Address Details
Address
114 W Delaware Ave
City
State
Zip
74048-2601
Phone Number
918-256-6476
Fax Number
918-256-3628
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Mental Health (Including Community Mental Health Center)
Taxonomy
License No.
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Definition
Definition to come...
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