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GRAND LAKE MENTAL HEALTH CENTER INC
NPI 1689206922
Clinic/Center - Mental Health (Including Community Mental Health Center) in Jay, OK

Active since February 05, 2020
1015 W WASHBOURNE ST, JAY, OK 74346(918) 381-9090(918) 273-1843 Get Directions Write a Review

NPPES record last updated: February 5, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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 1689206922), doing business as Grand Lake Medical Health Center, Inc., is a healthcare organization registered as a mental health (including community mental health center) in Jay, Oklahoma and active in the NPI registry since February 2020. The organization lists Charles Danley, Ceo, as its authorized official.

NPPES Registry Identity

NPI1689206922
Entity TypeOrganization
Primary Taxonomy261QM0801X
Legal Business NameGRAND LAKE MENTAL HEALTH CENTER INC
Location Address1015 W WASHBOURNE STJay, OK 74346-4205
Mailing Address114 W Delaware AveNowata, OK 74048-2601 · (918) 273-1841 · Fax (918) 273-1843
Phone(918) 381-9090
Fax(918) 273-1843
Organization SubpartNo
Authorized OfficialCharles DanleyCeo · (918) 273-1841
Enumeration DateFebruary 5, 2020
✔ NPI 1689206922 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
1015 W WASHBOURNE ST, Jay, OK 74346
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Other Names 1

Doing Business AsGrand Lake Medical Health Center, Inc.

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.

TRAVIS VIRON KERSH
Peer Specialist
1015 W WASHBOURNE ST
JAY, OK 74346
Delaware County (844) 458-2100
JADE ALEXANDRIA FRAZIER RN
Case Manager/Care Coordinator
1015 W WASHBOURNE ST
JAY, OK 74346
Delaware County (844) 458-2100
ALISHA DAWN HUGHES
Behavior Analyst
1015 W WASHBOURNE ST
JAY, OK 74346
Delaware County (918) 308-5513
ANDREW C WICKLINE
Case Manager/Care Coordinator
1015 W WASHBOURNE ST
JAY, OK 74346
Delaware County (918) 868-7489
ELIZABETH BUCHANAN
Counselor (Mental Health)
1015 W WASHBOURNE ST
JAY, OK 74346
Delaware County (918) 308-5513
MRS. KRISTEN LEANN BOLDRA
Peer Specialist
1015 W WASHBOURNE ST
JAY, OK 74346
Delaware County (918) 308-5513
KARLIE ROSE BUSH LPN
Licensed Practical Nurse
1015 W WASHBOURNE ST
JAY, OK 74346
Delaware County (844) 458-2100
DR. STEFAN SHANE HACKER DDS
Dentist
1015 W WASHBOURNE ST
JAY, OK 74346
Delaware County (918) 253-8696

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 1689206922. It was assigned to this organization in the NPPES registry on February 5, 2020. The provider is doing business as Grand Lake Medical Health Center, Inc..

Where is Grand Lake Mental Health Center Inc located?

Grand Lake Mental Health Center Inc is located at 1015 W Washbourne St, Jay, OK 74346. The listed phone number is (918) 381-9090.

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.

When was this NPI record last updated?

The NPPES record for Grand Lake Mental Health Center Inc was last updated on February 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.