SOUTHCENTRAL FOUNDATION (NPI# 1659924108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659924108 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Practice Address |
4441 Diplomacy Dr Anchorage AK 99508-5910 |
| Mailing Address |
Po Box 35198 Seattle WA 98124-5198 |
| Practice Telephone | 9077295418 |
| Practice Fax Number | 9077298607 |
| Mailing Telephone | 9077295418 |
| Mailing Fax Number | 9077298607 |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-07-23 |
| Authorized Official Name | RONALD LEE OLSON (VP OF FINANCE) |
| Authorized Official Telephone | 7017294939 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| KKGB SUD Services | 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 |
4441 DIPLOMACY DR |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-5910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588862684 | Patricia Jane Clark Capo | Obstetrics & Gynecology | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2007-07-10 |
| 1861010100 | Emani Secret | Behavior Technician | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2020-07-13 |
| 1720603095 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2020-06-12 |
| 1598399602 | Alex John Olson | Student in an Organized Health Care Education/Training Program | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2020-02-27 |
| 1124666730 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-12-13 |
| 1962040634 | Southcentral Foundation | Psychologist | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-12-12 |
| 1538721741 | Malcolm Henry Nichols | Behavior Technician | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-07-08 |
| 1124686076 | Southcentral Foundation | Behavioral Analyst | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-06-04 |
| 1750948170 | Allison Margaret Capps | Behavior Technician | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-05-21 |
| 1134786734 | Stephanie Lee Douglas | Licensed Practical Nurse | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-05-20 |
| 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.