SOUTHCENTRAL FOUNDATION (NPI# 1366973539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366973539 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Other Organization Name | BEHAVIORAL HEALTH AIDE PRACTIONER GROUP |
| Practice Address |
4501 Diplomacy Dr Anchorage AK 99508-5919 |
| Practice Telephone | 9077294955 |
| Mailing Telephone | 9077294955 |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |
| Authorized Official Name | RONALD LEE OLSON (VP OF FINANCE) |
| Authorized Official Telephone | 9077294939 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHCENTRAL FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 172V00000X | Community Health Worker | 20467 | AK | Other Service Providers |
| Y | 251S00000X | Community/Behavioral Health | 20467 | AK | Agencies |
| Other Name | Type Code |
|---|---|
| Behavioral Health Aide Practioner Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407466204 | Southcentral Foundation | Clinic/Center | 11495 N Callison St, Sutton, AK 99674 | 2020-08-06 |
| 1528600947 | Southcentral Foundation | Clinic/Center | 6901 E Tudor Rd Ste 8, Anchorage, AK 99507-1254 | 2019-10-17 |
| 1639722069 | Southcentral Foundation | Community/Behavioral Health | 4175 Tudor Centre Dr, Anchorage, AK 99508-5917 | 2019-07-24 |
| 1659924025 | Southcentral Foundation | Community/Behavioral Health | 4341 Tudor Centre Dr Ste 300, Anchorage, AK 99508-5904 | 2019-07-24 |
| 1720548035 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr Fl 5, Anchorage, AK 99508-5910 | 2019-03-22 |
| 1750854089 | Southcentral Foundation | Clinic/Center | 400 W Benson Blvd, Anchorage, AK 99503-3829 | 2019-01-09 |
| 1639652662 | Southcentral Foundation | Clinic/Center | 26341 Eklutna Village Rd, Chugiak, AK 99567-5148 | 2018-09-14 |
| 1811420391 | Southcentral Foundation | Clinic/Center | 1021 E 3rd Ave, Anchorage, AK 99501-6102 | 2017-04-11 |
| 1043767940 | Southcentral Foundation | Dentist | 11495 N. Callison Street, Sutton, AK 99674 | 2016-09-08 |
| 1689021776 | Southcentral Foundation | Clinic/Center | 755 A St, Anchorage, AK 99501-3625 | 2016-05-18 |
| Street Address |
4501 DIPLOMACY DR |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5919 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346284445 | Tony W. Mcclure | Dentist | 4501 Diplomacy Dr, Anchorage, AK 99508-5919 | 2006-06-16 |
| 1891304036 | Carol Ann Labrie | Speech-Language Pathologist | 4501 Diplomacy Dr, Anchorage, AK 99508-5919 | 2020-07-23 |
| 1902466824 | Brianna Michelle Aspelund | Social Worker | 4501 Diplomacy Dr, Anchorage, AK 99508-5919 | 2019-06-13 |
| 1679130264 | Angela A Holt | Counselor | 4501 Diplomacy Dr, Anchorage, AK 99508-5919 | 2019-05-20 |
| 1275011686 | Christopher Dunaway | Physician Assistant | 4501 Diplomacy Dr, Anchorage, AK 99508-5919 | 2018-07-30 |
| 1841708435 | Valerie Laine Unrein | Advanced Practice Midwife | 4501 Diplomacy Dr, Anchorage, AK 99508 | 2018-01-17 |
| 1417465279 | Emily Therese Skrocki | Nurse Practitioner | 4501 Diplomacy Dr, Anchorage, AK 99508-5919 | 2018-01-15 |
| 1760901870 | Christina Marie Bernier | Physician Assistant | 4501 Diplomacy Dr, Anchorage, AK 99508-5919 | 2017-09-11 |
| 1427590975 | Lauren Nevzuroff | Massage Therapist | 4501 Diplomacy Dr, Anchorage, AK 99508-5919 | 2016-11-15 |
| 1578013629 | Gianna Fay | Advanced Practice Midwife | 4501 Diplomacy Dr, Anchorage, AK 99508-5919 | 2016-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| 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. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483781 | Anchorage Community Mental Health Services, Inc | Community/Behavioral Health | 704 W 26th Ave, Anchorage, AK 99503-2532 | 2020-10-03 |
| 1184259855 | Alaska Youth and Family Network | Community/Behavioral Health | 740 Communications Ave, Anchorage, AK 99503-6000 | 2020-03-03 |
| 1033755798 | The Salvation Army, A California Corporation | Community/Behavioral Health | 1700 A Street, Anchorage, AK 99501 | 2019-11-18 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1639722069 | Southcentral Foundation | Community/Behavioral Health | 4175 Tudor Centre Dr, Anchorage, AK 99508-5917 | 2019-07-24 |
| 1659924025 | Southcentral Foundation | Community/Behavioral Health | 4341 Tudor Centre Dr Ste 300, Anchorage, AK 99508-5904 | 2019-07-24 |
| 1558878231 | Pinnacle Community Health, LLC | Community/Behavioral Health | 8080 Opal Cir, Anchorage, AK 99502-4542 | 2018-01-04 |
| 1497272470 | David Root | Community/Behavioral Health | 207 E Northern Lights Blvd Ste 212, Anchorage, AK 99503-2731 | 2017-08-29 |
| 1306393012 | Deon Burns | Community/Behavioral Health | 12725 Landmark St Apt B, Anchorage, AK 99515-3818 | 2016-09-10 |
| 1386199339 | Pcr Alaska LLC | Community/Behavioral Health | 1413 W 31st Ave, Anchorage, AK 99503-3624 | 2016-08-19 |
| Find all providers in ANCHORAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.