SOUTHCENTRAL FOUNDATION NPI 1639102882

NPI Information

NPI: 1639102882
Provider Name: SOUTHCENTRAL FOUNDATION

Doing Business As: BSD- PATHWAY HOME

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
4000 SAN ERNESTO AVE
ANCHORAGE, AK
ZIP 99508
Phone: (907) 729-5020
Get Directions

SOUTHCENTRAL FOUNDATION is a community based residential treatment facility mental illness in Anchorage, AK. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. SOUTHCENTRAL FOUNDATION NPI is 1639102882. The provider is registered as an organization entity type.
The provider Is Doing Business As Bsd- Pathway Home.

The provider's business location address is:

4000 SAN ERNESTO AVE
ANCHORAGE, AK
ZIP 99508-874
Phone: (907) 729-5020

The provider's authorized official is Ronald Lee Olson .
The authorized official title is Executive Vice President Finance and has the following contact phone number (907) 729-4939.

The enumeration date for this NPI number is 7/9/2006 and was last updated on 9/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320800000X	Community Based Residential Treatment Facility, Mental Illness		20467	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1000855	MEDICAID	ALASKA
2	1021095	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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