Southcentral Foundation

NPI #1407466204 in Sutton, Alaska

Provider Information

NPI Number: 1407466204
Entity Type: Organization
Organization Name: Southcentral Foundation
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Aug 6, 2020
Last Updated: Aug 6, 2020

Practice Location

Address: 11495 N CALLISON ST
City: Sutton
State: Alaska
ZIP Code: 99674
Phone: (907) 745-0704

Authorized Official

Name: RONALD LEE OLSON
Title: VP OF FINANCE
Phone: (701) 729-4939

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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