Grand Lake Mental Health Center INC

Clinic/Center, Mental Health (Including Community Mental Health Center) in Claremore, OK. Organization (NPI-2).

NPI number1134539141

StatusActive

Last updated in NPPESMar 30, 2021

Details

NPI: 1134539141
Entity type: Organization (NPI-2)
Legal business name: Grand Lake Mental Health Center INC
Organization subpart: No
Enumeration date: Apr 29, 2014
Certification date: Mar 30, 2021
Last updated: Mar 30, 2021

Medicare and OIG

Medicare enrolled (PECOS): Not in the Medicare enrollment file
Can order and refer: Not on the CMS order and referring list
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	–	Yes

Other names

Grand Lake Medical Health Center (Doing Business As)

Practice location

3100 Medical Pkwy
Claremore, OK 74017-1088

Phone 918-342-0770 · Fax 918-342-0087

Mailing address

114 W Delaware Ave
Nowata, OK 74048-2601

Phone 918-273-1841 · Fax 918-273-1843

Authorized official

Larry Smith
Ceo
9182731841

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Mental Health Clinic/Center (Including Community Mental Health Center) providers in Claremore, OK

All 12 Mental Health Clinic/Center (Including Community Mental Health Center) providers in Claremore · All 1,633 providers in Claremore

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