NPIMap

Organization Active NPI

Grand Lake Mental Health Center, Inc.

  • Community/Behavioral Health Agency
  • Pryor, OK
National Provider Identifier
1851975478
Registry record updated Jun 13, 2022
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
109 N Fairland St
Pryor, OK 74361-4203
Phone
(918) 825-1405
Fax
(918) 825-1406
NPI assigned
May 10, 2021
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Larry Smith
Title
Ceo
Phone
(918) 273-1841

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

National Provider Directory

National Provider Directory
Tax ID family
Grand Lake Mental Health Center Inc (106 organizations share this tax ID)

Locations

109 N Fairland St
Pryor, OK 74361
Phone (918) 825-1406

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

109 N Fairland St
Pryor, OK 74361-4203

Mailing address

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

Other names 1

NPPES NPI Registry
  • GRAND Mental Health Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 13, 2022.

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1851975478",
    "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": "109 N FAIRLAND ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614203",
            "telephone_number": "918-825-1405",
            "fax_number": "918-825-1406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND LAKE MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LARRY",
        "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GRAND Mental Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pryor, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.