Organization · NPI-2
Grand Lake Mental Health Center, INC.
Clinic/Center, Mental Health (Including Community Mental Health Center) · Alva, OK
NPI number1033038914
StatusActive
Last updated in NPPESJul 14, 2026
Details
- NPI
- 1033038914
- Entity type
- Organization (NPI-2)
- Legal business name
- Grand Lake Mental Health Center, INC.
- Organization subpart
- No
- Enumeration date
- Jul 14, 2026
- Certification date
- Jul 14, 2026
- Last updated
- Jul 14, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Other names
- Grand Mental Health (Doing Business As)
Practice location
604 Choctaw StAlva, OK 73717-1626
Phone 580-327-1112
Mailing address
114 W Delaware AveNowata, OK 74048-2601
Phone 918-273-1841 · Fax 918-273-1843
Authorized official
Joshua Cantwell
Ceo
9182731841
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