SOUTHCENTRAL FOUNDATION (NPI# 1689021776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689021776 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Other Organization Name | COVENANT HOUSE |
| Practice Address |
755 A St Anchorage AK 99501-3625 |
| Mailing Address |
4501 Diplomacy Dr Attn: Provider Enrollment Anchorage AK 99508-5919 |
| Practice Telephone | 9072721255 |
| Mailing Telephone | 9077294955 |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |
| Authorized Official Name | RONALD LEE OLSON (VP OF FINANCE) |
| Authorized Official Telephone | 9077294939 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
20467 | AK | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Covenant House | Other Name - Individual/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 |
| 1639537640 | Southcentral Foundation | Clinic/Center | 1 Flight Line Road, Port Alsworth, AK 99653 | 2016-02-04 |
| Street Address |
755 A ST |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99501-3625 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043855828 | Volunteers of America Alaska, Cov | Clinic/Center | 755 A St, Anchorage, AK 99501-3625 | 2019-11-15 |
| 1134788177 | Cheyenne Marie Astle | Behavior Technician | 755 A St, Anchorage, AK 99501-3625 | 2019-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093304 | Ryan Garcia | Military Health Care Provider | 673d Med Group, Jber, AK 99501 | 2020-11-02 |
| 1033755798 | The Salvation Army, A California Corporation | Community/Behavioral Health | 1700 A Street, Anchorage, AK 99501 | 2019-11-18 |
| 1740841170 | Christina Lynne Arent Cook | Registered Nurse | 8000 West End Rd, Anchorage, AK 99501 | 2019-06-26 |
| 1033770672 | Kathy Eileen Mailelle | Behavior Technician | 8000 West End Road, Anchorage, AK 99501 | 2019-06-25 |
| 1306312574 | Patricia Estella Gould | Marriage & Family Therapist | 731 N St, Anchorage, AK 99501 | 2018-10-15 |
| 1497235642 | Beth Alta Fletcher | Specialist | 737 W 5th Ave Ste 202, Anchorage, AK 99501 | 2018-08-17 |
| 1699289645 | Jae Won Lee | Dentist | 726 E. 9th Avenue, Anchorage, AK 99501 | 2017-11-29 |
| 1649797796 | Seong Guy Hyung | Dentist | 726 E 9th Avenue, Anchorage, AK 99501 | 2017-08-29 |
| 1871952705 | Warren Anderson | Massage Therapist | 737 West 5th Avenue Suite 202, Anchorage, AK 99501 | 2016-02-20 |
| 1780072603 | Epoch - Alaska Limited Liability Company | General Practice | 3074 Mt. View Drive, Suite 193, Anchorage, AK 99501 | 2014-12-30 |
| Find all providers in zip 99501 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487265690 | Whole Family Integrated Wellness LLC | Clinic/Center | 600 E 36th Ave Ste 300, Anchorage, AK 99503-4168 | 2020-08-11 |
| 1528600947 | Southcentral Foundation | Clinic/Center | 6901 E Tudor Rd Ste 8, Anchorage, AK 99507-1254 | 2019-10-17 |
| 1811420391 | Southcentral Foundation | Clinic/Center | 1021 E 3rd Ave, Anchorage, AK 99501-6102 | 2017-04-11 |
| 1154591451 | La Integrative Primary Care Centre Inc | Clinic/Center | 8811 Toloff St, Anchorage, AK 99507-3848 | 2008-03-03 |
| 1720603095 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2020-06-12 |
| 1124666730 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2019-12-13 |
| 1174027296 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr, Anchorage, AK 99508-5910 | 2018-03-22 |
| 1407360977 | Full Spectrum Health, LLC | Clinic/Center | 307 E Northern Lights Blvd Ste 201, Anchorage, AK 99503-2701 | 2017-11-20 |
| 1194130823 | Peak Neurology and Sleep Medicine, LLC | Clinic/Center | 2741 Debarr Rd Ste C308, Anchorage, AK 99508 | 2014-06-20 |
| 1659581635 | Alaska Center for Pediatrics, LLC | Clinic/Center | 2925 Debarr Rd, Suite 230, Anchorage, AK 99508-2959 | 2007-05-22 |
| 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.