Organization
SOUTHCENTRAL FOUNDATION
Active
Organization
SOUTHCENTRAL FOUNDATION
Active
Parent organization
SOUTHCENTRAL FOUNDATION
Other names
Behavioral Health Aide Practioner Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHCENTRAL FOUNDATION
Authorized official
RONALD LEE OLSON (VP OF FINANCE)
(907) 729-4939
Entity
Organization
Contact information
Practice address
4501 DIPLOMACY DR, ANCHORAGE, AK 99508-5919
(907) 729-4955
Mailing address
4501 DIPLOMACY DR, ANCHORAGE, AK 99508-5919
(907) 729-4955
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
20467
AK
251S00000X
Community/Behavioral Health Agency
Primary
20467
AK
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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