| Southcentral Foundation | |
|
10 Dnr Road Mcgrath AK 99627 | |
| (907) 524-3299 | |
| Not Available |
| Full Name | Southcentral Foundation |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 10 Dnr Road, Mcgrath, Alaska |
| Authorized Official Name and Position | Ronald Lee Olson (EXECUTIVE VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 9077294939 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southcentral Foundation Po Box 35198 Seattle WA 98124-5198 Ph: () - | Southcentral Foundation 10 Dnr Road Mcgrath AK 99627 Ph: (907) 524-3299 |
| NPI Number | 1730771783 |
|---|---|
| Provider Enumeration Date | 02/10/2021 |
| Last Update Date | 09/14/2023 |
| Certification Date | 09/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730771783 | NPI | - | NPPES |
| 1716569 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Southcentral Foundation Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 10 Dnr Road, Mcgrath, AK 99627 Phone: 907-524-3299 |