Full Name | Grand Mental Health |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 138 S. Main, Afton, Oklahoma |
Authorized Official Name and Position | Larry Smith (CEO) |
Authorized Official Contact | 9182731841 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Grand Mental Health 114 W Delaware Ave Nowata OK 74048-2601 Ph: (918) 257-4244 | Grand Mental Health 138 S. Main Afton OK 74331-1822 Ph: (918) 257-2444 |
NPI Number | 1316954431 |
---|---|
Provider Enumeration Date | 08/02/2006 |
Last Update Date | 06/07/2022 |
Certification Date | 06/07/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316954431 | NPI | - | NPPES |
100728510A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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› Verified 8 days ago
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