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GRAND MENTAL HEALTH
NPI 1003456732
Clinic/Center - Mental Health (Including Community Mental Health Center) in Perry, OK

Active since January 10, 2020CLIA 37D2173493 · Waiver
502 N 14TH ST, PERRY, OK 73077(918) 308-5512(580) 215-5767 Get Directions Write a Review

NPPES record last updated: June 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Grand Mental Health NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAND MENTAL HEALTH (NPI 1003456732) is a healthcare organization registered as a mental health (including community mental health center) in Perry, Oklahoma and active in the NPI registry since January 2020. The organization holds a CLIA Waiver certificate valid through October 14, 2027 and lists Larry Smith, Ceo, as its authorized official.

NPPES Registry Identity

NPI1003456732
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameGRAND LAKE MENTAL HEALTH CENTER, INC.
Location Address502 N 14TH STPerry, OK 73077-5022
Mailing Address114 W Delaware AveNowata, OK 74048-2601 · (918) 273-1841 · Fax (918) 273-1843
Phone(918) 308-5512
Fax(580) 215-5767
Organization SubpartNo
Authorized OfficialLarry SmithCeo · (918) 273-1841
Enumeration DateJanuary 10, 2020
Last NPPES UpdateJune 13, 2022
NPPES CertifiedJune 13, 2022
✔ NPI 1003456732 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
502 N 14TH ST, Perry, OK 73077
Open in Google Maps ↗

Other Names 1

Doing Business AsGrand Mental Health

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 37D2173493

Grand Mental Health · Perry, OK
Active · expires Oct 14, 2027
CLIA Number37D2173493
Laboratory TypeCcbhc
Certificate Effective DateOctober 15, 2025
Certificate Expiration DateOctober 14, 2027
Laboratory DirectorW John Mallgren
Laboratory Phone(918) 418-0994
Laboratory LocationGrand Mental Health502 N 14th St, Perry, OK 73077
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ASHLEY LYNN GARNER
Case Manager/Care Coordinator
502 N 14TH ST
PERRY, OK 73077
Noble County (844) 458-2100
KIERSTEN MCCUTCHAN
Case Manager/Care Coordinator
502 N 14TH ST
PERRY, OK 73077
Noble County (844) 458-2100
MALLORY FAITH STATER
Case Manager/Care Coordinator
502 N 14TH ST
PERRY, OK 73077
Noble County (918) 308-5512
STEPHANIE MORRIS
Social Worker
502 N 14TH ST
PERRY, OK 73077
Noble County (918) 984-5170
MAEGAN PHILLIPS
Case Manager/Care Coordinator
502 N 14TH ST
PERRY, OK 73077
Noble County (918) 308-5512
DIANA SAMARRIPA
Counselor (Addiction (Substance Use Disorder))
502 N 14TH ST
PERRY, OK 73077
Noble County (918) 308-5512
GRAND LAKE MENTAL HEALTH CENTER, INC.
Clinic/Center (Mental Health (Including Community Mental Health Center))
502 N 14TH ST
PERRY, OK 73077
Noble County (918) 305-5512
MISS LATOSHA MARIE SEAGROVES
Peer Specialist
502 N 14TH ST
PERRY, OK 73077
Noble County (844) 458-2100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grand Lake Mental Health Center, Inc.'s NPI number?

The NPI number for Grand Lake Mental Health Center, Inc. is 1003456732. It was assigned to this organization in the NPPES registry on January 10, 2020. The provider is doing business as Grand Mental Health.

Where is Grand Lake Mental Health Center, Inc. located?

Grand Lake Mental Health Center, Inc. is located at 502 N 14th St, Perry, OK 73077. The listed phone number is (918) 308-5512.

What is Grand Lake Mental Health Center, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

Does Grand Lake Mental Health Center, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 37D2173493) is associated with this NPI, valid through October 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Grand Lake Mental Health Center, Inc. was last updated on June 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.