# SOUTHCENTRAL FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHCENTRAL FOUNDATION
- **Other names:** Tribal- Kokhanok Community Health Clinic
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1043689169
- **Legal business name:** SOUTHCENTRAL FOUNDATION
- **Authorized official:** RONALD LEE OLSON (EXECUTIVE VICE PRESIDENT OF FINANCE)
- **Authorized official phone:** (907) 729-4939

## Contact information

- **Practice address:** 1008 MAIN STREET, KOKHANOK, AK 99606
- **Practice address phone:** (907) 282-2203
- **Mailing address:** PO BOX 35198, SEATTLE, WA 98124-5198

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 20467 | AK | Yes |

## Other

- **Enumeration date:** 09/18/2015
- **Last updated:** 08/30/2023