Organization
SOUTHCENTRAL FOUNDATION
Active
Parent organization
SOUTHCENTRAL FOUNDATION
Other names
Tribal- Brother Francis Shelter
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHCENTRAL FOUNDATION
Authorized official
RONALD LEE OLSON (EXECUTIVE VICE PRESIDENT FINANCE)
(907) 729-4949
Entity
Organization
Contact information
Practice address
1021 E 3RD AVE, ANCHORAGE, AK 99501-6102
(907) 222-7300
Mailing address
PO BOX 35198, SEATTLE, WA 98124-5198
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
20467
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1667521
—
AK
Enumeration date
04/11/2017
Last updated
09/15/2023
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