SOUTHCENTRAL FOUNDATION (NPI# 1184678559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184678559 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Other Organization Name | DENA A COY (RESIDENTIAL) |
| Practice Address |
4130 San Ernesto Ave Anchorage AK 99508-2875 |
| Mailing Address |
4201 Tudor Centre Dr Suite 320 Anchorage AK 99508-5904 |
| Practice Telephone | 9077294955 |
| Mailing Telephone | 9077294955 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2010-12-15 |
| Authorized Official Name | DAVID MORGAN (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 9077294955 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0400X |
Clinic/Center Specialization: Rehabilitation |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Dena A Coy (Residential) | 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 |
4130 SAN ERNESTO AVE |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99508-2875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041436 | Valerie Janine Shaver | Case Manager/Care Coordinator | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2020-10-20 |
| 1750928545 | Taliah Wood | Behavior Technician | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2019-11-29 |
| 1699329003 | Southcentral Foundation | Community/Behavioral Health | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2019-07-25 |
| 1689230443 | Michon Stevens | Social Worker | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2019-05-16 |
| 1043876022 | Karen Miranda Corpuz | Behavior Technician | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2019-05-15 |
| 1487210555 | Trachelle Stepney | Behavior Technician | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2019-05-14 |
| 1902462088 | Natasha Kahele | Behavior Technician | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2019-05-14 |
| 1144886326 | Amy Jones Bugh | Counselor | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2019-05-14 |
| 1205492576 | Desiree L Montalbo | Counselor | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2019-05-13 |
| 1659937928 | Monica L Byrd | Behavior Technician | 4130 San Ernesto Ave, Anchorage, AK 99508-2875 | 2019-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063349 | Alexandra L Davis | Student in an Organized Health Care Education/Training Program | 1202 E 36th Ave, Anchorage, AK 99508 | 2020-05-01 |
| 1366087108 | The Salvation Army, A California Corporation | Community/Behavioral Health | 3600 East 20th Avenue, Anchorage, AK 99508 | 2019-11-15 |
| 1679120349 | Kila Gilcart | Speech-Language Pathologist | 161 Klevin Street #103, Anchorage, AK 99508 | 2019-08-19 |
| 1326692963 | Shannon Maillet | Behavior Technician | 1650 S Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1427602044 | Frank Harris Lawson Iv | Behavior Technician | 1650 S. Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1104470723 | Vivalesi Seforosa Nair | Behavior Technician | 1650 South Bragaw, Anchorage, AK 99508 | 2019-07-31 |
| 1043864267 | The Cozy Chalet Assisted Living Home LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3707 Mt Blanc Circle, Anchorage, AK 99508 | 2019-07-25 |
| 1942861778 | Christine Mary Hoover | Registered Nurse | Alaska Native Medical Center - Inpatient Pediatrics, 4315 Diplomacy Dr, Anchorage, AK 99508 | 2019-06-24 |
| 1215594502 | Ashley Ongtowasruk | Case Manager/Care Coordinator | 4441 Dipomacy Dr, Suite 500, Anchorage, AK 99508 | 2019-05-22 |
| 1659937019 | Rayne Johnson | Behavior Technician | 4000 San Ernesto Blvd, Anchorage, AK 99508 | 2019-05-11 |
| Find all providers in zip 99508 | ||||
| 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 |
| 1144274986 | Southcentral Foundation | Clinic/Center | 225 Eagle St, Anchorage, AK 99501-2626 | 2006-05-19 |
| 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 |
Please comment or provide details below to improve the information on SOUTHCENTRAL FOUNDATION.
| 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.