GRAND LAKE MENTAL HEALTH CENTER, INC.
NPI 1366802860
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 February 26, 2016

6333 E SKELLY DR, TULSA, OK 74135(918) 664-4224(918) 664-8732 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, May 26, 2022, Feb 26, 2016 (3 updates tracked since 2016).

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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 1366802860), doing business as 12&12 Inc Outpatient Services, is a healthcare organization registered as a community/behavioral health in Tulsa, Oklahoma and active in the NPI registry since February 2016. The organization maintains a secondary practice location in Tulsa and lists Larry Smith, Ceo, as its authorized official.

NPPES Registry Identity

NPI1366802860

Entity TypeOrganization

Primary Taxonomy251S00000X

Legal Business NameGRAND LAKE MENTAL HEALTH CENTER, INC.

Location Address6333 E SKELLY DRTulsa, OK 74135-6106

Mailing Address6333 E Skelly DrTulsa, OK 74135-6106 · (918) 664-4224 · Fax (918) 664-8732

Phone(918) 664-4224

Fax(918) 664-8732

Organization SubpartNo

Authorized OfficialLarry SmithCeo · (918) 273-1841

Enumeration DateFebruary 26, 2016

Last NPPES UpdateJune 7, 20223 updates tracked since enumeration

NPPES CertifiedJune 7, 2022

✔ NPI 1366802860 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 ListedClinic/Center · Mental Health (Including Community Mental Health Center)Taxonomy 261QM0801X

6333 E SKELLY DR, Tulsa, OK 74135

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Other Names 2

Former Legal Business Name12&12 Inc Outpatient Services

Doing Business AsGrand Mental Health

Secondary Practice Location 1

Location 11214 S Baltimore AveTulsa, OK 74119-2804 · Phone (918) 664-4224 · Fax (918) 663-0203

Other Identifiers 1

Medicaid100737580AOK

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