NPIMap

Organization Active NPI

Southcentral Foundation

Doing business as The Pathway Home Rendezvous

  • Psychiatric Residential Treatment Facility
  • Anchorage, AK
National Provider Identifier
1194987370
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
20467 Issued in AK
Legal business name
SOUTHCENTRAL FOUNDATION
Doing business as
The Pathway Home Rendezvous
Practice address
4353 Rendezvous Cir
Anchorage, AK 99504-4219
Phone
(907) 729-5020
NPI assigned
Jun 27, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ronald Lee Olson
Title
VP of Finance
Phone
(907) 729-4939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 20467 AK Primary

Addresses

Primary practice location

4353 Rendezvous Cir
Anchorage, AK 99504-4219

Mailing address

4501 Diplomacy Dr
Attn: Provider Enrollment
Anchorage, AK 99508-5919
Phone (907) 729-4955

Other names 1

  • The Pathway Home Rendezvous Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anchorage Primary Care Clinic103 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1194987370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 DIPLOMACY DR",
            "address_2": "ATTN: PROVIDER ENROLLMENT",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085919",
            "telephone_number": "907-729-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4353 RENDEZVOUS CIR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995044219",
            "telephone_number": "907-729-5020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCENTRAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-27",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "907-729-4939"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "AK",
            "license": "20467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Pathway Home Rendezvous",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.