SOUTHCENTRAL FOUNDATION NPI 1255881637

NPI Information

NPI: 1255881637
Provider Name: SOUTHCENTRAL FOUNDATION
Classification: Clinic/Center - 261QM1300X
Specialization: Multi-Specialty
Entity Type: Organization
Doing Business As: BSD- DETOX
Address: 4330 ELMORE RD
ANCHORAGE, AK
ZIP 99508
Phone: (907) 729-6690

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NPI Details

SOUTHCENTRAL FOUNDATION is a multi-specialty clinic center in Anchorage, AK. SOUTHCENTRAL FOUNDATION NPI is 1255881637. The provider is registered as an organization entity type.
The provider Is Doing Business As Bsd- Detox.

The provider's business location address is:

4330 ELMORE RD
ANCHORAGE, AK
ZIP 99508-907
Phone: (907) 729-6690

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) 729-4949.

The enumeration date for this NPI number is 10/10/2016 and was last updated on 8/31/2023.

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	251S00000X	Community/Behavioral Health				No
2	261QM1300X	Clinic/Center	Multi-Specialty			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	1664351	MEDICAID	ALASKA
2	1666501	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: 3/30/2025

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