Organization
SOUTHCENTRAL FOUNDATION
Active
Other names
Newhalen
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD LEE OLSON (VP FINANCE)
(907) 729-4939
Entity
Organization
Contact information
Practice address
102 FIREWEED LANE, NEWHALEN, AK 99606
(907) 571-1231
(907) 571-1551
Mailing address
4501 DIPLOMACY DR, ATTN: FINANCE/PROVIDER ENROLLMENT, ANCHORAGE, AK 99508-5919
(907) 729-4955
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
20467
AK
Other
Enumeration date
09/16/2015
Last updated
09/16/2015
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