| Grand Lake Mental Health Center, Inc. | |
|
1370 Se Washington Blvd Bartlesville OK 74006-4519 | |
| (918) 337-8080 | |
| (918) 337-8099 |
| Full Name | Grand Lake Mental Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1370 Se Washington Blvd, Bartlesville, Oklahoma |
| Authorized Official Name and Position | Charles Danley (CEO) |
| Authorized Official Contact | 9182731841 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Lake Mental Health Center, Inc. 114 W Delaware Ave Nowata OK 74048-2601 Ph: (918) 273-1841 | Grand Lake Mental Health Center, Inc. 1370 Se Washington Blvd Bartlesville OK 74006-4519 Ph: (918) 337-8080 |
| NPI Number | 1033759972 |
|---|---|
| Provider Enumeration Date | 01/08/2020 |
| Last Update Date | 01/08/2020 |
| Certification Date | 01/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033759972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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Grand Mental Health Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1370 Se Washington Blvd, Bartlesville, OK 74006 Phone: 918-337-8080 | |
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