Organization
SOUTHCENTRAL FOUNDATION
Active
Organization
SOUTHCENTRAL FOUNDATION
Active
Parent organization
SOUTHCENTRAL FOUNDATION
Other names
SUD/BH 1115- VNPCC, BH 1115- Benteh Nuutah Primary Care Center, BH 1115- VNPCC
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHCENTRAL FOUNDATION
Authorized official
RONALD LEE OLSON (EXECUTIVE VICE PRESIDENT OF FINANCE)
(907) 729-4939
Entity
Organization
Contact information
Practice address
1001 S KNIK GOOSE BAY RD, WASILLA, AK 99654-8083
(907) 631-7800
Mailing address
PO BOX 35198, SEATTLE, WA 98124-5198
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1696887
—
AK
Enumeration date
07/22/2019
Last updated
06/05/2026
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