Organization
SOUTHCENTRAL FOUNDATION
Active
Organization
SOUTHCENTRAL FOUNDATION
Active
Other names
The Pathway Home Cottonwood
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD LEE OLSON (VP FINANCE)
(907) 729-4939
Entity
Organization
Contact information
Practice address
3550 COTTONWOOD ST, ANCHORAGE, AK 99508-4352
(907) 729-2500
Mailing address
4501 DIPLOMACY DR, ATTN: PROVIDER ENROLLMENT, ANCHORAGE, AK 99508-5919
(907) 729-4955
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/01/2008
Last updated
10/15/2024
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