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Organization

SOUTHCENTRAL FOUNDATION

Active
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Organization

SOUTHCENTRAL FOUNDATION

Active
Parent organization
SOUTHCENTRAL FOUNDATION
Other names
HPG- CHAP GROUP
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
4320 DIPLOMACY DR, ANCHORAGE, AK 99508-5925
(907) 729-4955
Mailing address
PO BOX 35198, SEATTLE, WA 98124-5198

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
20467
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1651471
AK
Enumeration date
04/27/2012
Last updated
08/31/2023
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