Provider Demographics
NPI:1306733142
Name:PARKSIDE BEHAVIOR HOMES
Entity type:Organization
Organization Name:PARKSIDE BEHAVIOR HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STELUTA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-800-9593
Mailing Address - Street 1:18006 N 6TH DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-6489
Mailing Address - Country:US
Mailing Address - Phone:602-800-9593
Mailing Address - Fax:
Practice Address - Street 1:18006 N 6TH DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-6489
Practice Address - Country:US
Practice Address - Phone:602-800-9593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness