NPIMap

Organization Active NPI

Grand Lake Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Tulsa, OK
National Provider Identifier
1356048656
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GRAND LAKE MENTAL HEALTH CENTER, INC.
Practice address
6111 E Skelly Dr
Tulsa, OK 74135-6100
Phone
(918) 664-4224
Fax
(918) 663-0303
NPI assigned
Feb 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Joshua Cantwell
Title
Ceo
Phone
(918) 273-1841

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

6111 E Skelly Dr
Tulsa, OK 74135-6100

Mailing address

6111 E Skelly Dr
Tulsa, OK 74135-6100
Phone (918) 664-4224

Other names 1

  • Grand Mental Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091026000174 OK Part B Supplier - Clinic/Group Practice 4688711534 Receives reassigned benefits from 341 practitioners
44 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pawhuska, OK; Perry, OK; Ponca City, OK; Pryor, OK; Skiatook, OK; Stillwater, OK; Claremore, OK; Tulsa, OK…

Other NPIs on the same Medicare enrollment 44

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 44

National Provider Directory

National Provider Directory
Tax ID family
Grand Lake Mental Health Center Inc106 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1370 SE Washington Blvd
Bartlesville, OK 74006

1313 W Ferguson Ave
Blackwell, OK 74631
Phone (580) 363-4400

111 W Delaware Ave
Nowata, OK 74048
Phone (918) 273-7344

9432 N May Ave
Ste D
Oklahoma City, OK 73120
Phone (405) 608-8041

502 N 14th St
Perry, OK 73077
Phone (918) 308-5512

2225 N Union St
Ponca City, OK 74601
Phone (580) 308-5515

231 E Graham Ave
Pryor, OK 74361

1624 Cimarron Plz
Stillwater, OK 74075
Phone (800) 722-3611

2109 S Highway 69
Wagoner, OK 74467
Phone (918) 485-0242

3186 Highway 412
West Siloam Springs, OK 74338
Phone (918) 708-3006

Practitioners & affiliated clinicians

Practitioners 388

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 388

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1356048656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6111 E SKELLY DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356100",
            "telephone_number": "918-664-4224",
            "fax_number": "918-663-0303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6111 E SKELLY DR",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356100",
            "telephone_number": "918-664-4224",
            "fax_number": "918-663-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND LAKE MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-08",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "CANTWELL",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-273-1841"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.