| Southcentral Foundation | |
|
26341 Eklutna Village Rd Chugiak AK 99567-5148 | |
| (907) 688-6031 | |
| (907) 688-6021 |
| Full Name | Southcentral Foundation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 26341 Eklutna Village Rd, Chugiak, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (VP OF REVENUE) |
| Authorized Official Contact | 7017294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southcentral Foundation Po Box 35198 Chugiak AK 99567-5148 Ph: (907) 688-6731 | Southcentral Foundation 26341 Eklutna Village Rd Chugiak AK 99567-5148 Ph: (907) 688-6031 |
| NPI Number | 1144830837 |
|---|---|
| Provider Enumeration Date | 08/06/2020 |
| Last Update Date | 08/17/2020 |
| Certification Date | 08/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144830837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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