PARKSIDE, INC. (NPI# 1437370772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437370772 |
| Entity Type | Organization |
| Organization Name | PARKSIDE, INC. |
| Other Organization Name | PARKSIDE INPATIENT HOSPITAL |
| Practice Address |
1619 East 13th Street Tulsa OK 74120-5410 |
| Mailing Address |
1619 East 13th Street Tulsa OK 74120 |
| Practice Telephone | 9185822131 |
| Mailing Telephone | 9185822131 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2014-12-24 |
| Authorized Official Name | MRS. SAUNYA D. MOORE (CFO) |
| Authorized Official Telephone | 9185822131 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OK | 100738360H | 05 |
| Other Name | Type Code |
|---|---|
| Parkside Inpatient Hospital | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346461688 | Parkside, Inc. | Psychiatric Residential Treatment Facility | 1619 E 13th St, Tulsa, OK 74120-5410 | 2007-05-02 |
| 1164643409 | Parkside, Inc. | Psychiatric Residential Treatment Facility | 1220 S Trenton Ave, Tulsa, OK 74120-5421 | 2007-05-02 |
| 1134750649 | Parkside, Inc. | Clinic/Center | 1239 S Trenton Ave, Tulsa, OK 74120-5420 | 2020-02-03 |
| 1750714721 | Parkside, Inc. | Psychiatric Hospital | 1619 E 13th St, Tulsa, OK 74120-5410 | 2013-08-14 |
| 1326396391 | Parkside, Inc. | Psychiatric Hospital | 1220 S Trenton Ave, Tulsa, OK 74120-5421 | 2012-08-24 |
| 1205135936 | Parkside, Inc. | Psychiatric Unit | 1220 S Trenton Ave, Tulsa, OK 74120-5421 | 2011-03-21 |
| 1548573348 | Parkside, Inc. | Clinic/Center | 1220 S Trenton Ave, Tulsa, OK 74120-5421 | 2010-07-21 |
| 1356552111 | Parkside, Inc. | Clinic/Center | 1620 E 12th St, Tulsa, OK 74120-5407 | 2007-05-24 |
| 1851327464 | Parkside, Inc. | Clinic/Center | 1620 E 12th St, Tulsa, OK 74120-5407 | 2006-06-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | PARKSIDE, INC. | 253 Amenia Union Road, Sharon, CT 06069 |
| Oklahoma Business Registrations | PARKSIDE, INC. | 1620 E 12th St, Tulsa, OK 74120 |
| Street Address |
1619 EAST 13TH STREET |
| City | TULSA |
| State | OK |
| Zip Code | 74120-5410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144704321 | Quintella Delana Miller | Case Manager/Care Coordinator | 1043 E Easton St, Tulsa, OK 74120 | 2018-09-24 |
| 1689152092 | Charles Granger Jr. | Case Manager/Care Coordinator | 103 N Greenwood, Suite 320, Tulsa, OK 74120 | 2018-07-30 |
| 1174015598 | Debra Anne Beasley | Counselor | 1619 E. 13th St., Tulsa, OK 74120 | 2018-06-01 |
| 1649775701 | Cara Marie Cantu | Licensed Practical Nurse | 620 South Peoria, Tulsa, OK 74120 | 2018-03-29 |
| 1639558745 | Wei Te Li | Student in an Organized Health Care Education/Training Program | 1207 S Quaker Ave Apt 104, Tulsa, OK 74120 | 2015-05-21 |
| 1225434350 | Marcos Rivero | Community/Behavioral Health | 130 N. Greenwood, Suite 302, Tulsa, OK 74120 | 2014-11-18 |
| 1861742348 | Tamiika Jones | Social Worker | 1533 E 13th St, Apt B, Tulsa, OK 74120 | 2012-09-12 |
| 1730408097 | Teresa Lee Henshaw | Physical Therapist | 1125 S. Trenton, Hillcrest Medical Center- Kaiser Rehab. Center, Tulsa, OK 74120 | 2010-05-26 |
| 1194970384 | Kym Lynnette Lindsay | Speech-Language Pathologist | 1125 S Trenton Ave Fl 3, Tulsa, OK 74120 | 2008-12-01 |
| 1184872004 | Board of Regents of The University of Oklahoma Ou Physicians Tulsa | Pediatrics | 619 S. Quincy Ave., Ouptch-laura Dester Shelter, Tulsa, OK 74120 | 2008-09-04 |
| Find all providers in zip 74120 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104224856 | Erica Gregory | Psychiatric Hospital | 211 S Garnett Rd, Tulsa, OK 74128-1805 | 2014-12-11 |
| 1982005971 | Shadow Mountain Behavioral Health System, LLC | Psychiatric Hospital | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2014-09-09 |
| 1902224801 | Shadow Mountain Behavioral Health System, LLC | Psychiatric Hospital | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2014-03-29 |
| 1750714721 | Parkside, Inc. | Psychiatric Hospital | 1619 E 13th St, Tulsa, OK 74120-5410 | 2013-08-14 |
| 1174866875 | Parkside Psychiatric Hospital & Clinic | Psychiatric Hospital | 1619 E 13th St, 1620 E. 12th, Tulsa, OK 74120-5410 | 2013-04-01 |
| 1326396391 | Parkside, Inc. | Psychiatric Hospital | 1220 S Trenton Ave, Tulsa, OK 74120-5421 | 2012-08-24 |
| 1710296272 | Shadow Mountain Behavioral Health | Psychiatric Hospital | 6262 S Sheridan Rd, Tulsa, OK 74133-4055 | 2010-10-01 |
| 1891988424 | John B White, Md PC | Psychiatric Hospital | 1620 E 12th St, Tulsa, OK 74120-5407 | 2007-08-27 |
| 1083807366 | Oklahoma Medical and Psychiatric Services Inc | Psychiatric Hospital | 2913 E 88th St, Tulsa, OK 74137-2508 | 2007-08-21 |
| 1174660518 | Brookhaven Hospital Inc. | Psychiatric Hospital | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2007-02-01 |
| Find all providers in TULSA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.