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GRAND MENTAL HEALTH
NPI 1063429181
Clinic/Center - Mental Health (Including Community Mental Health Center) in Grove, OK

Active since August 02, 2006CLIA 37D2083589 · Waiver
1115 HARBOR RD, GROVE, OK 74344(918) 786-4434(918) 786-4435 Get Directions Write a Review

NPPES record last updated: June 7, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 7, 2022, Jul 31, 2020, May 10, 2019 (3 updates tracked since 2019).

About Grand Mental Health NPPES

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

GRAND MENTAL HEALTH (NPI 1063429181) is a healthcare organization registered as a mental health (including community mental health center) in Grove, Oklahoma and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through September 8, 2026 and lists Larry Smith, Ceo, as its authorized official.

NPPES Registry Identity

NPI1063429181
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameGRAND LAKE MENTAL HEALTH CENTER, INC.
Location Address1115 HARBOR RDGrove, OK 74344-3505
Mailing Address114 W Delaware AveNowata, OK 74048-2601 · (918) 786-4434 · Fax (918) 786-4435
Phone(918) 786-4434
Fax(918) 786-4435
Organization SubpartNo
Authorized OfficialLarry SmithCeo · (918) 273-1841
Enumeration DateAugust 2, 2006
Last NPPES UpdateJune 7, 20223 updates tracked since enumeration
NPPES CertifiedJune 7, 2022
✔ NPI 1063429181 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
1115 HARBOR RD, Grove, OK 74344
Open in Google Maps ↗

Other Names 1

Doing Business AsGrand Mental Health

Other Identifiers 1

Medicaid100728510OOK

Accepted Insurance

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

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 37D2083589

Grand Mental Health Jurc · Jay, OK
Active · expires Sep 8, 2026
CLIA Number37D2083589
Laboratory TypePhysician Office
Certificate Effective DateSeptember 9, 2024
Certificate Expiration DateSeptember 8, 2026
Laboratory DirectorJohn Mallgren
Laboratory Phone(918) 786-4434
Laboratory LocationGrand Mental Health Jurc1015 W Washbourne, Jay, OK 74346
CLIA data matches this NPI record on: Name Phone
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.

SHERI THOMAS
Case Manager/Care Coordinator
1115 HARBOR RD
GROVE, OK 74344
Delaware County (918) 786-4434
JAMES WALLS
Counselor (Mental Health)
1115 HARBOR RD
GROVE, OK 74344
Delaware County (918) 786-4434
JOSHUA PAUL RAMOS
Case Manager/Care Coordinator
1115 HARBOR RD
GROVE, OK 74344
Delaware County (918) 786-4434
DENISE ANN WHIPKEY
Case Manager/Care Coordinator
1115 HARBOR RD
GROVE, OK 74344
Delaware County (918) 786-4434
JAQUELYNN JEAN WOOD
Registered Nurse
1115 HARBOR RD
GROVE, OK 74344
Delaware County (918) 786-4434
ANDREA M DESILVA
Case Manager/Care Coordinator
1115 HARBOR RD
GROVE, OK 74344
Delaware County (918) 786-4434
MARY ELLEN POLLETT
Peer Specialist
1115 HARBOR RD
GROVE, OK 74344
Delaware County (918) 786-4434
CINDY MATTHEWS
Case Manager/Care Coordinator
1115 HARBOR RD
GROVE, OK 74344
Delaware County (918) 786-4434

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 1063429181. It was assigned to this organization in the NPPES registry on August 2, 2006. 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 1115 Harbor Rd, Grove, OK 74344. The listed phone number is (918) 786-4434.

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 37D2083589) is associated with this NPI, valid through September 8, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Grand Lake Mental Health Center, Inc. accept?

Health plans from Blue Cross and Blue Shield of Oklahoma list Grand Lake Mental Health Center, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grand Lake Mental Health Center, Inc. was last updated on June 7, 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.