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SOUTHCENTRAL FOUNDATION NPI 1366973539


NPI Profile

NPI: 1366973539
Provider Name: SOUTHCENTRAL FOUNDATION

Doing Business As: BEHAVIORAL HEALTH AIDE PRACTIONER GROUP

Classification:Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 02D1031480

Address:
4501 DIPLOMACY DR
ANCHORAGE, AK
ZIP 99508
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Phone: (907) 729-4955

SOUTHCENTRAL FOUNDATION is a community behavioral health in Anchorage, AK. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. SOUTHCENTRAL FOUNDATION NPI is 1366973539. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Behavioral Health Aide Practioner Group.

The provider's business location address is:

4501 DIPLOMACY DR
ANCHORAGE, AK
ZIP 99508-919
Phone: (907) 729-4955

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

The CLIA number assigned to this NPI record is 02D1031480 - other with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/21/2017 and was last updated on 3/21/2017.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1172V00000XCommunity Health Worker20467ALASKANo
2251S00000XCommunity/Behavioral Health20467ALASKAYes

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: 3/9/2021

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