GRAND LAKE MENTAL HEALTH CENTER, INC.
NPI 1053317883
Community/Behavioral Health in Tulsa, OK

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

The primary specialty registered for this NPI is Community/Behavioral Health with taxonomy code 251S00000X.

Active since June 27, 2005

6333 E SKELLY DR, TULSA, OK 74135(918) 664-4224(918) 663-0203 Get Directions Write a Review

NPPES record last updated: October 17, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 7, 2022, May 26, 2022, Aug 22, 2020 (3 updates tracked since 2020).

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About Grand Lake Mental Health Center, Inc. NPPES

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

GRAND LAKE MENTAL HEALTH CENTER, INC. (NPI 1053317883), doing business as Grand Mental Health, is a healthcare organization registered as a community/behavioral health in Tulsa, Oklahoma and active in the NPI registry since June 2005. The organization lists Joshua Cantwell, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053317883

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameGRAND LAKE MENTAL HEALTH CENTER, INC.

Location Address6333 E SKELLY DRTulsa, OK 74135-6106

Mailing Address114 W Delaware AveNowata, OK 74048-2601 · (918) 273-1841 · Fax (918) 273-1843

Phone(918) 664-4224

Fax(918) 663-0203

Organization SubpartNo

Authorized OfficialJoshua CantwellCeo · (918) 273-1841

Enumeration DateJune 27, 2005

Last NPPES UpdateOctober 17, 20253 updates tracked since enumeration

NPPES CertifiedOctober 17, 2025

✔ NPI 1053317883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity/Behavioral HealthAgencies

Taxonomy Code251S00000X

Definition

A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X · License 640AD (OK)

6333 E SKELLY DR, Tulsa, OK 74135

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Other Names 2

Doing Business AsGrand Mental Health

Former Legal Business Name12 & 12, Inc

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Oklahoma.Insurance ›

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.

JERRY LEE MANUS

Case Manager/Care Coordinator