Organization
SOUTHCENTRAL FOUNDATION
Active
Parent organization
SOUTHCENTRAL FOUNDATION
Other names
BH 1115- Child & Family Outpatient Services (South, BH 115- Child & Family Outpatient Services (East), BH 1115-Child & Family Outpatient Services (West)
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
3000 C ST STE 115, ANCHORAGE, AK 99503-3975
(907) 729-8558
Mailing address
PO BOX 35198, SEATTLE, WA 98124-5198
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1725109
—
AK
05
—
1725111
—
AK
05
—
1727040
—
AK
Enumeration date
09/10/2021
Last updated
10/13/2023
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