| NPI | 1659952497 |
|---|---|
| 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 | 2021-04-14 |
| Last Update Date | 2021-04-14 |