Organization
SOUTHCENTRAL FOUNDATION
Active
Other names
Cleveland Home
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A MORGAN (DIRECTOR OF REIMBURSEMENT)
(907) 729-4955
Entity
Organization
Contact information
Practice address
1701 CLEVELAND AVE, ANCHORAGE, AK 99517-2689
(907) 729-6370
Mailing address
4201 TUDOR CENTRE DRIVE, SUITE 320, ANCHORAGE, AK 99508-5904
(907) 729-8624
(907) 729-8607
Taxonomy
Speciality
Code
Description
License number
State
323P00000X
Psychiatric Residential Treatment Facility
Primary
20467
AK
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MH6076
—
AK
Enumeration date
06/26/2007
Last updated
09/01/2010
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