# SOUTHCENTRAL FOUNDATION

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHCENTRAL FOUNDATION
- **Other names:** Tribal- Indian Creek Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1609232040
- **Legal business name:** SOUTHCENTRAL FOUNDATION
- **Authorized official:** RONALD LEE OLSON (EXECUTIVE VICE PRESIDENT FINANCE)
- **Authorized official phone:** (907) 729-4939

## Contact information

- **Practice address:** 101 INDIAN CREEK ROAD, TYONEK, AK 99682
- **Practice address phone:** (907) 583-2461
- **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:** 01/14/2016
- **Last updated:** 09/14/2023