Organization · Type 2 NPI
Grand Lake Mental Health Center, Inc.
Mental Health Clinic/Center (Including Community Mental Health Center) · Oklahoma City, OK
NPI number
1104167204
Active
Practice location
9430 N May Ave
Oklahoma City, OK 73120-2712
Mailing address
114 W Delaware Ave
Nowata, OK 74048-2601
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Clinic/Center (Including Community Mental Health Center) Primary | 261QM0801X | None listed |
Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...
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About NPI 1104167204
Grand Lake Mental Health Center, Inc.'s National Provider Identifier is 1104167204, issued on Mar 14, 2013. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Oklahoma City, OK. The record was last updated on Mar 14, 2013.