Organization
PARKSIDE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM ERIC SACHAU (DIRECTOR OF BUSINESS DEVELOPMENT)
(918) 588-8826
Entity
Organization
Contact information
Practice address
1220 S TRENTON AVE, TULSA, OK 74120-5421
(918) 588-8874
Mailing address
1620 E 12TH ST, TULSA, OK 74120-5407
(918) 588-8874
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
2261
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100738360L
—
OK
Enumeration date
03/21/2011
Last updated
02/15/2022
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