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Organization

SOUTHCENTRAL FOUNDATION

Active
Parent organization
SOUTHCENTRAL FOUNDATION
Other names
BH 1115- McGrath
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
10 DNR ROAD, MCGRATH, AK 99627
(907) 524-3299
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
1716569
AK
Enumeration date
02/10/2021
Last updated
09/14/2023
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