| NPI | 1073889036 |
|---|---|
| Former Legal Business Name | 12 & 12, INC |
| Doing Business As | GRAND MENTAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | LARRY SMITH CEO 918-273-1841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: OK 234500000x) |
| Enumeration Date | 2012-03-23 |
| Last Update Date | 2022-06-07 |