Provider Demographics
NPI:1780216507
Name:PARKES STOVEPIPE INC
Entity Type:Organization
Organization Name:PARKES STOVEPIPE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKE
Authorized Official - Suffix:
Authorized Official - Credentials:CASUDC
Authorized Official - Phone:435-610-1696
Mailing Address - Street 1:230 N 1680 E STE D1
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2576
Mailing Address - Country:US
Mailing Address - Phone:435-610-1696
Mailing Address - Fax:
Practice Address - Street 1:230 N 1680 E STE D1
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2576
Practice Address - Country:US
Practice Address - Phone:435-610-1696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty