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Organization

PARKSIDE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM ERIC SACHAU (DIRECTOR OF BUSINESS DEVELOPMENT)
(918) 588-8826
Entity
Organization

Contact information

Practice address
1239 S TRENTON AVE, TULSA, OK 74120-5420
(918) 582-2131
(918) 588-8822
Mailing address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 582-2131
(918) 588-8822

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center
283Q00000X
Psychiatric Hospital
Primary

Other

Enumeration date
02/03/2020
Last updated
02/03/2020
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