Organization · Type 2 NPI

Southcentral Foundation

Community/Behavioral Health Agency · Pedro Bay, AK

NPI number 1780287920 Active

Practice location

2516 Mountain Circle
Pedro Bay, AK 99647

Call (907) 850-2229 Map

Mailing address

PO Box 35198
Seattle, WA 98124-5198

Specialties and licenses

Taxonomy	Code	License
Community/Behavioral Health Agency Primary	251S00000X	None listed

Community/Behavioral Health Agency: A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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 suppo…

3 other providers at this address

NPI record

NPI: 1780287920
Entity type: Organization (Type 2)
Issued: Nov 19, 2020
Last updated: Sep 15, 2023
Status: Active
Subpart: Yes of Southcentral Foundation

Other names

<unavail>
BH 1115- Pedro Bay · doing business as

Authorized official

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

Verify this record

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.

Is this your record? How to update it.

About NPI 1780287920

Southcentral Foundation's National Provider Identifier is 1780287920, issued on Nov 19, 2020. The primary taxonomy on file is Community/Behavioral Health Agency (251S00000X), and the practice location is in Pedro Bay, AK. The record was last updated on Sep 15, 2023.