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)
  • Nowata, OK
National Provider Identifier
1902487747
Registry record updated Apr 14, 2021
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
325 S Ash St
Nowata, OK 74048-4628
Phone
(918) 273-7344
Fax
(918) 999-0111
NPI assigned
Apr 14, 2021
Last updated
Apr 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Authorized official

Name
Larry SmithNPI 1699217091
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 NU Primary

Addresses

Primary practice location

325 S Ash St
Nowata, OK 74048-4628

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 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

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": "1618358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1902487747",
    "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": "325 S ASH ST",
            "city": "NOWATA",
            "state": "OK",
            "postal_code": "740484628",
            "telephone_number": "918-273-7344",
            "fax_number": "918-999-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND LAKE MENTAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-14",
        "last_updated": "2021-04-14",
        "certification_date": "2021-03-23",
        "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": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Lake Medical Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nowata, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2021; 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.