Organization
SOUTHCENTRAL FOUNDATION
Active
Parent organization
SOUTHCENTRAL FOUNDATION
Other names
Care Coordination - Waiver Care Coordination
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHCENTRAL FOUNDATION
Authorized official
RONALD LEE OLSON (EXECUTIVE VICE PRESIDENT FINANCE)
(907) 729-4939
Entity
Organization
Contact information
Practice address
4160 TUDOR CENTRE DR, ANCHORAGE, AK 99508-5901
(907) 729-6365
Mailing address
PO BOX 35198, SEATTLE, WA 98124-5198
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
20467
AK
251B00000X
Case Management Agency
Primary
20467
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002717
—
AK
Enumeration date
02/20/2008
Last updated
08/31/2023
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