SOUTHCENTRAL FOUNDATION (NPI# 1861698623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861698623 |
| Entity Type | Organization |
| Organization Name | SOUTHCENTRAL FOUNDATION |
| Other Organization Name | CLEVELAND HOME |
| Practice Address |
1701 Cleveland Ave Anchorage AK 99517-2689 |
| Mailing Address |
4201 Tudor Centre Drive Suite 320 Anchorage AK 99508-5904 |
| Practice Telephone | 9077296370 |
| Mailing Telephone | 9077298624 |
| Mailing Fax Number | 9077298607 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2010-09-01 |
| Authorized Official Name | DAVID A MORGAN (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Telephone | 9077294955 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
| Y | 323P00000X | Psychiatric Residential Treatment Facility | 20467 | AK | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AK | MH6076 | 05 |
| Other Name | Type Code |
|---|---|
| Cleveland Home | 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 |
1701 CLEVELAND AVE |
| City | ANCHORAGE |
| State | AK |
| Zip Code | 99517-2689 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417448036 | Oasis Assisted Living Home LLC | Assisted Living Facility | 1701 Cleveland Ave, Anchorage, AK 99517-2689 | 2018-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871905679 | Luminary LLC | Massage Therapist | 1838 W. Northern Lights, Anchorage, AK 99517 | 2014-05-28 |
| 1447595129 | Antonina Ivanovna Shangraw | Behavioral Analyst | 2425 Captain Cook Dr, Anchorage, AK 99517 | 2012-12-06 |
| 1407000755 | James N. Duchanin | Physician Assistant | 3105 Lakeshore Dr., Bldg A, Ste 101, Anchorage, AK 99517 | 2008-11-13 |
| 1720290786 | Turnagain Foster Home | Assisted Living Facility | 2812 West 29th Ave, Anchorage, AK 99517 | 2007-05-04 |
| 1124244306 | Turnagain Foster Home | Taxi | 2900 West 29th Ave, Anchorage, AK 99517 | 2007-04-17 |
| 1497825798 | Scott Paul Mackie | Internal Medicine | 3710 Woodland Road, Suite 1100, Anchorage, AK 99517 | 2006-11-08 |
| 1629046446 | Ana Verzone | Nurse Practitioner | 3740 Clay Products Dr., Anchorage, AK 99517 | 2006-03-08 |
| 1740897503 | Far North Urology & Research PC | Urology | 2120 Sonstrom Dr, Anchorage, AK 99517-1018 | 2020-09-25 |
| 1376697011 | Celia Foley | Speech-Language Pathologist | 2515 Telequana Dr, Anchorage, AK 99517-1028 | 2007-01-22 |
| 1730122946 | Daryl A Young | Nurse Practitioner | 3611 Knik Avenue, Anchorage, AK 99517-1045 | 2006-06-14 |
| Find all providers in zip 99517 | ||||
| Taxonomy Code | 323P00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Psychiatric Residential Treatment Facility |
| A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
| Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710149661 | Southcentral Foundation | Psychiatric Residential Treatment Facility | 3550 Cottonwood St, Anchorage, AK 99508-4352 | 2008-07-01 |
| 1194987370 | Southcentral Foundation | Psychiatric Residential Treatment Facility | 4353 Rendezvous Cir, Anchorage, AK 99504-4219 | 2008-06-27 |
| 1437271400 | Alaska Children's Services, Inc. | Psychiatric Residential Treatment Facility | 4600 Abbott Rd, Anchorage, AK 99507 | 2007-04-03 |
| 1356416101 | Frontline Residential Treatment Center LLC | Psychiatric Residential Treatment Facility | 1500 Debarr Circle, Anchorage, AK 99508 | 2006-11-21 |
| 1841364957 | Frontlline Residential Treatment Center LLC | Psychiatric Residential Treatment Facility | 1650 Bragaw St, Anchorage, AK 99508-3435 | 2006-11-20 |
| 1659483113 | Providence Health & Services - Washington | Psychiatric Residential Treatment Facility | 3210 W 62nd Ave, Anchorage, AK 99502 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689749939 | Frontline Residential Treatment Center LLC | Psychiatric Residential Treatment Facility | Mile 2.5 Clark Wolverine Rd, Palmer, AK 99645 | 2006-11-22 |
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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.