# SOUTHCENTRAL FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cleveland Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861698623
- **Authorized official:** DAVID A MORGAN (DIRECTOR OF REIMBURSEMENT)
- **Authorized official phone:** (907) 729-4955

## Contact information

- **Practice address:** 1701 CLEVELAND AVE, ANCHORAGE, AK 99517-2689
- **Practice address phone:** (907) 729-6370
- **Mailing address:** 4201 TUDOR CENTRE DRIVE, SUITE 320, ANCHORAGE, AK 99508-5904
- **Mailing address phone:** (907) 729-8624
- **Mailing address fax:** (907) 729-8607

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 323P00000X | Psychiatric Residential Treatment Facility | 20467 | AK | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | — | — | — |

## Other

- **Enumeration date:** 06/26/2007
- **Last updated:** 09/01/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | MH6076 | — | AK |