| Organization Name: | SOUTHCENTRAL FOUNDATION |
| NPI Number: | 1043632037 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONALD LEE OLSON (VP OF FINANCE) |
| Mailing Address: | 11495 N Callison Street Sutton |
| State: | AK US |
| Postal Code: | 99674 |
| Phone Number: | 9077450704 |
| Fax Number: | |
| NPI Enumeration Date: | 01/10/2014 |
| NPI Last Update Date: | 03/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | 20467 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |