# SOUTH CORRECTIONAL ENTITY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851198212
- **Authorized official:** DEVON SCHRUM (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (206) 257-6262

## Contact information

- **Practice address:** 20817 17TH AVE S, DES MOINES, WA 98198-7665
- **Practice address phone:** (206) 257-6200
- **Mailing address:** 20817 17TH AVE S, DES MOINES, WA 98198-7665
- **Mailing address phone:** (206) 257-6200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2400X | Prison Health Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 02/25/2025
- **Last updated:** 02/25/2025