NPI | 1235534355 |
---|---|
Doing Business As | GRAND LAKE MEDICAL HEALTH CENTER |
Entity Type | Organization |
Authorized Contact | LARRY SMITH CEO 918-273-1841 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2014-10-31 |
Last Update Date | 2020-07-31 |