| NPI | 1356552111 |
|---|---|
| Other Name | PARKSIDE PROFESSIONAL |
| Entity Type | Organization |
| Authorized Contact | SAUNYA D. MOORE CFO 918-588-8874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: OK 2261) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: OK 2261) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2012-10-31 |