SOUTHCENTRAL FOUNDATION (NPI# 1003469719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003469719 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Practice Address |
1001 S Knik Goose Bay Rd Wasilla AK 99654-8083 |
| Mailing Address |
Po Box 35198 Seattle WA 98124-5198 |
| Practice Telephone | 9077295418 |
| Practice Fax Number | 9077298607 |
| Mailing Telephone | 9077295418 |
| Mailing Fax Number | 9077298607 |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2019-07-22 |
| Authorized Official Name | RONALD LEE OLSON (VP OF FINANCE) |
| Authorized Official Telephone | 7017294939 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Valley SUD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407466204 | Southcentral Foundation | Clinic/Center | 11495 N Callison St, Sutton, AK 99674 | 2020-08-06 |
| 1528600947 | Southcentral Foundation | Clinic/Center | 6901 E Tudor Rd Ste 8, Anchorage, AK 99507-1254 | 2019-10-17 |
| 1639722069 | Southcentral Foundation | Community/Behavioral Health | 4175 Tudor Centre Dr, Anchorage, AK 99508-5917 | 2019-07-24 |
| 1659924025 | Southcentral Foundation | Community/Behavioral Health | 4341 Tudor Centre Dr Ste 300, Anchorage, AK 99508-5904 | 2019-07-24 |
| 1720548035 | Southcentral Foundation | Clinic/Center | 4441 Diplomacy Dr Fl 5, Anchorage, AK 99508-5910 | 2019-03-22 |
| 1750854089 | Southcentral Foundation | Clinic/Center | 400 W Benson Blvd, Anchorage, AK 99503-3829 | 2019-01-09 |
| 1639652662 | Southcentral Foundation | Clinic/Center | 26341 Eklutna Village Rd, Chugiak, AK 99567-5148 | 2018-09-14 |
| 1811420391 | Southcentral Foundation | Clinic/Center | 1021 E 3rd Ave, Anchorage, AK 99501-6102 | 2017-04-11 |
| 1043767940 | Southcentral Foundation | Dentist | 11495 N. Callison Street, Sutton, AK 99674 | 2016-09-08 |
| 1689021776 | Southcentral Foundation | Clinic/Center | 755 A St, Anchorage, AK 99501-3625 | 2016-05-18 |
| Street Address |
1001 S KNIK GOOSE BAY RD |
| City | WASILLA |
| State | AK |
| Zip Code | 99654-8083 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245285964 | Laurie Elizabeth Dahms | Family Medicine | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2006-05-23 |
| 1154947570 | Heather Hamilton | Advanced Practice Midwife | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2020-06-22 |
| 1356964662 | Allison Michelle Hillen | Dietitian, Registered | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2020-05-20 |
| 1619526381 | Emily K Wood | Counselor | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-09-05 |
| 1114573284 | Emily Marie Schmitt | Nurse Practitioner | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-08-14 |
| 1225683709 | Jolie Miller | Registered Nurse | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-08-01 |
| 1497317168 | Tarah Ruth Desatoff | Optometrist | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-07-02 |
| 1417518143 | Holli Blake | Social Worker | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-06-24 |
| 1831755560 | Kathy Bowman | Case Manager/Care Coordinator | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-05-17 |
| 1730745472 | Brenda Michele Paradise | Case Manager/Care Coordinator | 1001 S Knik Goose Bay Rd, Wasilla, AK 99654-8083 | 2019-05-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003426784 | Colleen Maggie Newcity | Case Manager/Care Coordinator | 851 Westpoint Suite 310, Wasilla, AK 99654 | 2020-08-06 |
| 1659995884 | Amy M Lowe | Peer Specialist | 1363 W Spuce Ave, Wasilla, AK 99654 | 2020-06-03 |
| 1922648690 | Achieve Medical Alaska LLC | Clinic/Center | 1981 E Palmer, Suite 230, Wasilla, AK 99654 | 2020-01-10 |
| 1588205538 | Juan Carlos Garcia | Physician Assistant | 950 East Bogard Road, Suite 103, Wasilla, AK 99654 | 2019-10-01 |
| 1427610864 | Sharon Webb | Counselor | 705 S Knik Goose Bay Rd Suite K, Wasilla, AK 99654 | 2019-07-06 |
| 1306401864 | Logan Lee Cook | Peer Specialist | 2953 E Fairview Loop, Wasilla, AK 99654 | 2019-05-09 |
| 1053883595 | Moose Creek Medical Clinic LLC | Nurse Practitioner | 2341 S. Fern St., Suite 300, Wasilla, AK 99654 | 2018-12-21 |
| 1487124962 | Melissa A Stevens | Massage Therapist | 2201 W That Rd, Wasilla, AK 99654 | 2018-11-28 |
| 1609359561 | Audrey E Beers | Midwife | 2405 S. Knik Goose Bay Rd., Wasilla, AK 99654 | 2018-09-07 |
| 1093297418 | Karlee Janine Mccorry | Occupational Therapist | 613 S Knik-goose Bay Rd, Wasilla, AK 99654 | 2018-09-01 |
| Find all providers in zip 99654 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427670330 | Advanced Neuro Solutions | Community/Behavioral Health | 1075 S Check St Ste 211, Wasilla, AK 99654-8067 | 2020-05-13 |
| 1558980706 | Gentle Hands Care Assisted Living Home LLC | Community/Behavioral Health | 4092 W Marble Way, Wasilla, AK 99654-8752 | 2020-04-08 |
| 1578196192 | Hab Academy LLC | Community/Behavioral Health | 4314 S Pinnacle Peak Dr, Wasilla, AK 99623-0707 | 2020-02-21 |
| 1942830419 | Family Centered Services of Alaska | Community/Behavioral Health | 301 Danna Ave, Wasilla, AK 99654-5521 | 2020-01-23 |
| 1700422029 | Set Free Alaska, Inc. | Community/Behavioral Health | 7010 E Bogard Rd Bldg 2, Wasilla, AK 99654-4711 | 2019-11-21 |
| 1730621731 | Alaska Behavior Consultants | Community/Behavioral Health | 3861 S Cardiff Lane, Wasilla, AK 99623-1085 | 2016-11-08 |
| 1811301716 | Co Occuring Disorders Institute | Community/Behavioral Health | 280 W Sheridan Cir Apt 1, Wasilla, AK 99654-0526 | 2014-06-18 |
| 1235558016 | Alaska Full Circle Counseling Solutions LLC | Community/Behavioral Health | 133 E Swanson Ave, Wasilla, AK 99654-7025 | 2014-04-09 |
| 1073841789 | Set Free Alaska, Inc. | Community/Behavioral Health | 7010 E Bogard Rd Bldg 1, Wasilla, AK 99654-4711 | 2009-11-19 |
| 1043481088 | Ascent Treatment Counseling Services, LLC | Community/Behavioral Health | 5431 E Mayflower Ln Ste 5, Wasilla, AK 99654-7891 | 2008-03-18 |
| Find all providers in WASILLA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.