Organization · Type 2 NPI

Grand Lake Mental Health Center, Inc.

Community/Behavioral Health Agency · Tulsa, OK

NPI number 1073889036 Active

Practice location

6333 E Skelly Dr
Tulsa, OK 74135-6106

Call (918) 664-4224 Map

Fax (918) 663-0203

Other practice locations

1214 S Baltimore Ave, Tulsa, OK 74119-2804 · (918) 664-4224

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency Primary	251S00000X	None listed
Substance Abuse Rehabilitation Facility	324500000X	234500000X (OK)

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day suppo…

416 other providers at this address

Other community/behavioral health agency providers in Tulsa

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NPI record

NPI: 1073889036
Entity type: Organization (Type 2)
Issued: Mar 23, 2012
Last updated: Jun 7, 2022
Status: Active

Other names

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Grand Mental Health · doing business as
12 & 12, Inc · former legal business name
12 & 12, Inc · former legal business name

Authorized official

Larry Smith
CEO
(918) 273-1841

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1073889036

Grand Lake Mental Health Center, Inc.'s National Provider Identifier is 1073889036, issued on Mar 23, 2012. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Tulsa, OK. The record was last updated on Jun 7, 2022.