| Grand Lake Therapeutics Llc | |
|
1441 Lakeside Dr Grove OK 74344-4223 | |
| (918) 786-0875 | |
| Not Available |
| Full Name | Grand Lake Therapeutics Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1441 Lakeside Dr, Grove, Oklahoma |
| Authorized Official Name and Position | Mitzy Kantor (OWNER) |
| Authorized Official Contact | 9187860875 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grand Lake Therapeutics Llc 1441 Lakeside Dr Grove OK 74344-4223 Ph: () - | Grand Lake Therapeutics Llc 1441 Lakeside Dr Grove OK 74344-4223 Ph: (918) 786-0875 |
| NPI Number | 1528670239 |
|---|---|
| Provider Enumeration Date | 08/24/2020 |
| Last Update Date | 08/24/2020 |
| Certification Date | 08/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528670239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Grand Lake Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1115 Harbor Rd, Grove, OK 74344 Phone: 918-786-4434 Fax: 918-786-4435 | |
Yco, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1107 E 13th St, Grove, OK 74344 Phone: 866-926-6552 Fax: 580-323-6152 | |
Grand Lake Mental Health Center Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1115 S Harber Rd, Grove, OK 74344 Phone: 918-786-4434 | |
Skm Solutions, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 103 E 1st St, Grove, OK 74344 Phone: 918-786-7111 Fax: 918-786-7116 | |
Grand Lake Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1115 Harbor Rd, Grove, OK 74344 Phone: 918-786-4434 Fax: 918-786-4435 | |
Grand Lake Mental Health Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 Harber Rd, Grove, OK 74344 Phone: 918-786-4434 Fax: 918-786-4435 |