NPIMap

Organization Active NPI

Grand Lake Mental Health Center, Inc.

Doing business as Grand Lake Medical Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grove, OK
National Provider Identifier
1760022602
Registry record updated Jan 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
GRAND LAKE MENTAL HEALTH CENTER, INC.
Doing business as
Grand Lake Medical Health Center
Practice address
1010 Harbor Rd
Grove, OK 74344-5147
Phone
(918) 786-4434
Fax
(918) 786-4435
NPI assigned
Jan 8, 2020
Last updated
Jan 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2020

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

Authorized official

Name
Charles DanleyNPI 1023238235
Title
Ceo
Phone
(918) 273-1841

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1010 Harbor Rd
Grove, OK 74344-5147

Mailing address

114 W Delaware Ave
Nowata, OK 74048-2601
Phone (918) 273-1841

Other names 1

  • Grand Lake Medical Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Grand Lake Mental Health Center Inc108 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

1010 Harbor Rd
Grove, OK 74344

114 W Delaware Ave
Nowata, OK 74048
Phone 91827318412207

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578441600000",
    "number": "1760022602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W DELAWARE AVE",
            "city": "NOWATA",
            "state": "OK",
            "postal_code": "740482601",
            "telephone_number": "918-273-1841",
            "fax_number": "918-273-1843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 HARBOR RD",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743445147",
            "telephone_number": "918-786-4434",
            "fax_number": "918-786-4435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND LAKE MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A",
        "authorized_official_last_name": "DANLEY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "918-273-1841"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Lake Medical Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grove, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.