SOUTHCENTRAL FOUNDATION (NPI# 1144274986) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144274986 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Other Organization Name | QUYANA CLUB HOUSE MENTAL HEALTH CLINIC |
| Practice Address |
225 Eagle St Anchorage AK 99501-2626 |
| Mailing Address |
4501 Diplomacy Dr Attn: Provider Enrollment Anchorage AK 99508-5919 |
| Practice Telephone | 9077296550 |
| Mailing Telephone | 9077294955 |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2016-03-15 |
| Authorized Official Name | RONALD LEE OLSON (VP FINANCE) |
| Authorized Official Telephone | 9077294939 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
20467 | AK | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Quyana Club House Mental Health Clinic | 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 |
225 EAGLE ST |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99501-2626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033775663 | Bonnie Jean Hughes | Counselor | 225 Eagle St, Anchorage, AK 99501-2626 | 2019-05-20 |
| 1003473604 | Terra Marie Gallant | Behavior Technician | 225 Eagle St, Anchorage, AK 99501-2626 | 2019-05-20 |
| 1487210043 | Chris George | Behavior Technician | 225 Eagle St, Anchorage, AK 99501-2626 | 2019-05-18 |
| 1780240515 | Carol Jane Rook | Registered Nurse | 225 Eagle St, Anchorage, AK 99501-2626 | 2019-05-16 |
| 1477119345 | Aaron David Bass | Behavior Technician | 225 Eagle St, Anchorage, AK 99501-2626 | 2019-05-15 |
| 1528624491 | Abdou Kemo Marenah | Behavior Technician | 225 Eagle St, Anchorage, AK 99501-2626 | 2019-05-15 |
| 1962068023 | Molly Katherine Jacobson | Behavior Technician | 225 Eagle St, Anchorage, AK 99501-2626 | 2019-05-14 |
| 1154987428 | Ren Lynn Bell | Behavior Technician | 225 Eagle St, Anchorage, AK 99501-2626 | 2019-05-13 |
| 1548826936 | Erika Irene Kalilikane | Behavior Technician | 225 Eagle St, Anchorage, AK 99501-2626 | 2019-05-12 |
| 1255996849 | Amanda J. Marrion | Behavior Technician | 225 Eagle St, Anchorage, AK 99501-2626 | 2019-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093304 | Ryan Garcia | Military Health Care Provider | 673d Med Group, Jber, AK 99501 | 2020-11-02 |
| 1033755798 | The Salvation Army, A California Corporation | Community/Behavioral Health | 1700 A Street, Anchorage, AK 99501 | 2019-11-18 |
| 1740841170 | Christina Lynne Arent Cook | Registered Nurse | 8000 West End Rd, Anchorage, AK 99501 | 2019-06-26 |
| 1033770672 | Kathy Eileen Mailelle | Behavior Technician | 8000 West End Road, Anchorage, AK 99501 | 2019-06-25 |
| 1306312574 | Patricia Estella Gould | Marriage & Family Therapist | 731 N St, Anchorage, AK 99501 | 2018-10-15 |
| 1497235642 | Beth Alta Fletcher | Specialist | 737 W 5th Ave Ste 202, Anchorage, AK 99501 | 2018-08-17 |
| 1699289645 | Jae Won Lee | Dentist | 726 E. 9th Avenue, Anchorage, AK 99501 | 2017-11-29 |
| 1649797796 | Seong Guy Hyung | Dentist | 726 E 9th Avenue, Anchorage, AK 99501 | 2017-08-29 |
| 1871952705 | Warren Anderson | Massage Therapist | 737 West 5th Avenue Suite 202, Anchorage, AK 99501 | 2016-02-20 |
| 1780072603 | Epoch - Alaska Limited Liability Company | General Practice | 3074 Mt. View Drive, Suite 193, Anchorage, AK 99501 | 2014-12-30 |
| Find all providers in zip 99501 | ||||
| Taxonomy Code | 261QR0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013445972 | Alaska Premier Assisted Living LLC | Clinic/Center | 4635 E 4th Ave, Anchorage, AK 99508-2218 | 2017-05-23 |
| 1619147881 | A T G Inc | Clinic/Center | 300 E Dimond Blvd Ste 12, Anchorage, AK 99515-1948 | 2008-03-04 |
| 1184678559 | Southcentral Foundation | Clinic/Center | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2006-05-20 |
| 1265059174 | Outstanding Therapy Solutions LLC | Clinic/Center | 4300 B St Ste 104, Anchorage, AK 99503-5926 | 2020-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619946530 | Select Physical Therapy Holdings Inc | Clinic/Center | 3455 Rewak Drive, Suite 106, Fairbanks, AK 99709 | 2006-03-14 |
| 1699743484 | Select Physical Therapy Holdings Inc | Clinic/Center | 17101 Snowmobile Ln, Suite 202, Eagle River, AK 99577-7043 | 2006-03-09 |
| 1548890569 | Select Physical Therapy Holdings Inc | Clinic/Center | 33455 Sterling Highway, Sterling, AK 99672 | 2020-01-17 |
| 1821418948 | Talk Sense | Clinic/Center | 11823 Old Glenn Hwy, 108, Eagle River, AK 99577-7734 | 2014-04-16 |
| 1982957015 | Providence Medical Center | Clinic/Center | 417 First Ave, Seward, AK 99664-0365 | 2012-10-26 |
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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.