Organization
SOUTHCENTRAL FOUNDATION
Active
Parent organization
SOUTHCENTRAL FOUNDATION
Other names
BSD- Valley Native Primary Care Center- VNPCC
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
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
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1697883
—
AK
Enumeration date
11/23/2010
Last updated
08/31/2023
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