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NPI Code Detail

MEDICARE: PARKSIDE, INC.

MEDICARE: PARKSIDE, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0850XAdult Mental Health Clinic/Center
2261QM0855XAdolescent and Children Mental Health Clinic/Center
3283Q00000XPsychiatric Hospital

General Provider Information

NPI Number : 1134750649
Entity Type Code : Organization
Provider Name (Legal Business Name) : PARKSIDE, INC.
Provider Business Mailing Address
First Line : 1239 S TRENTON AVE
Second Line :
City : TULSA
State : OK
Zip : 74120-5420
Country : US
Telephone Number : 918-582-2131
Fax Number : 918-588-8822
Provider Business Practice Location Address
First Line : 1239 S TRENTON AVE
Second Line :
City : TULSA
State : OK
Zip : 74120-5420
Country : US
Telephone Number : 918-582-2131
Fax Number : 918-588-8822
Authorized Official
Title or Position : DIRECTOR OF BUSINESS DEVELOPMENT
Name : WILLIAM ERIC SACHAU
Credential :
Telephone Number : 918-588-8826
Provider Enumeration Date : 02/03/2020
Last Update Date : 05/26/2026

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Directions to “PARKSIDE, INC. ” Practice Location

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