Organization · Type 2 NPI

Southcentral Foundation

Mental Illness Community Based Residential Treatment Facility · Anchorage, AK

NPI number 1639102882 Active

Practice location

4000 San Ernesto Ave
Anchorage, AK 99508-2874

Call (907) 729-5020 Map

Mailing address

PO Box 35198
Seattle, WA 98124-5198

Specialties and licenses

Taxonomy	Code	License
Mental Illness Community Based Residential Treatment Facility Primary	320800000X	20467 (AK)

Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

77 other providers at this address

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NPI record

NPI: 1639102882
Entity type: Organization (Type 2)
Issued: Jul 9, 2006
Last updated: Sep 14, 2023
Status: Active
Subpart: Yes of Southcentral Foundation

Other names

<unavail>
Bsd- Pathway Home · doing business as

Authorized official

Ronald Lee Olson
Executive Vice President Finance
(907) 729-4939

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1639102882

Southcentral Foundation's National Provider Identifier is 1639102882, issued on Jul 9, 2006. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Anchorage, AK. The record was last updated on Sep 14, 2023.