SOUTHCENTRAL FOUNDATION NPI 1689021776

NPI Information

NPI: 1689021776
Provider Name: SOUTHCENTRAL FOUNDATION

Doing Business As: TRIBAL- THE COVENANT HOUSE

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

Address:
755 A ST
ANCHORAGE, AK
ZIP 99501
Phone: (907) 272-1255
Get Directions

SOUTHCENTRAL FOUNDATION is a multi-specialty clinic center in Anchorage, AK. SOUTHCENTRAL FOUNDATION NPI is 1689021776. The provider is registered as an organization entity type.
The provider Is Doing Business As Tribal- The Covenant House.

The provider's business location address is:

755 A ST
ANCHORAGE, AK
ZIP 99501-625
Phone: (907) 272-1255

The provider's authorized official is Ronald Lee Olson .
The authorized official title is Executive Vice President Finance and has the following contact phone number (907) 729-4939.

The enumeration date for this NPI number is 5/18/2016 and was last updated on 9/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM1300X	Clinic/Center	Multi-Specialty	20467	ALASKA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1658963	MEDICAID	ALASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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