Provider Demographics
NPI:1720011828
Name:PARKSIDE BEHAVIORAL HEALTHCARE ACQUISITION INC
Entity Type:Organization
Organization Name:PARKSIDE BEHAVIORAL HEALTHCARE ACQUISITION INC
Other - Org Name:THE WOODS AT PARKSIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:O'SHEA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:813-978-1933
Mailing Address - Street 1:7074 GROVE RD STE 129
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8658
Mailing Address - Country:US
Mailing Address - Phone:523-597-5075
Mailing Address - Fax:
Practice Address - Street 1:349 OLDE RIDENOUR RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-2528
Practice Address - Country:US
Practice Address - Phone:614-471-2552
Practice Address - Fax:614-471-0167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH283Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH360247Medicare Oscar/Certification