Grand Mental Health | |
405 E Excelsior Ave Vinita OK 74301-4226 | |
(918) 256-6476 | |
(918) 256-3628 |
Full Name | Grand Mental Health |
---|---|
Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 405 E Excelsior Ave, Vinita, 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) 256-6476 | Grand Mental Health 405 E Excelsior Ave Vinita OK 74301-4226 Ph: (918) 256-6476 |
NPI Number | 1710994835 |
---|---|
Provider Enumeration Date | 08/02/2006 |
Last Update Date | 06/07/2022 |
Certification Date | 06/07/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1710994835 | NPI | - | NPPES |
100732860F | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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