| NPI | 1366802860 |
|---|---|
| Doing Business As | GRAND MENTAL HEALTH |
| Former Legal Business Name | 12&12 INC OUTPATIENT SERVICES |
| Entity Type | Organization |
| Authorized Contact | LARRY SMITH CEO 918-273-1841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2022-06-07 |