Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Grand Lake Mental Health Center, Inc

Organization Community/Behavioral Health Agency · NPI 1053317883

Grand Lake Mental Health Center, Inc is a Community/Behavioral Health Agency in Tulsa, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2005.

Licensed in
OK
In the registry since
2005
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

6333 E Skelly Dr
Tulsa, OK 74135-6106
Phone: (918) 664-4224
Fax: (918) 663-0203
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X
Substance Abuse Rehabilitation Facility Taxonomy 324500000X · Licence 640AD (OK)

Record details

NPI number1053317883
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joshua Cantwell — Ceo · (918) 273-1841
Other names Grand Mental Health; 12 & 12, Inc; 12 & 12, Inc
NPI enumeratedJune 27, 2005
Last updated in NPPESOctober 17, 2025
Certification dateOctober 17, 2025
Mailing address114 W Delaware Ave, Nowata, OK 74048-2601

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