| Southcentral Foundation | |
|
1008 Main Street Kokhanok AK 99606 | |
| (907) 282-2203 | |
| Not Available |
| Full Name | Southcentral Foundation |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1008 Main Street, Kokhanok, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (VP FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southcentral Foundation 4501 Diplomacy Dr Anchorage AK 99508-5919 Ph: (907) 729-4955 | Southcentral Foundation 1008 Main Street Kokhanok AK 99606 Ph: (907) 282-2203 |
| NPI Number | 1609235738 |
|---|---|
| Provider Enumeration Date | 02/17/2016 |
| Last Update Date | 03/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609235738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 20467 (Alaska) | Primary |