Active NPI
Southcentral Foundation
Doing business as BH- PCC
- Community/Behavioral Health Agency
- Anchorage, AK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- SOUTHCENTRAL FOUNDATION
- Doing business as
- BH- PCC
Sud 1115- PCC - Practice address
- 4320 Diplomacy Dr
Anchorage, AK 99508-5925 - Phone
- (907) 729-3300
- NPI assigned
- Jul 24, 2019
- Last updated
- Sep 25, 2025
- Organization subpart
- Yes
- Parent organization
- SOUTHCENTRAL FOUNDATION
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ronald Lee Olson
- Title
- Executive Vice President Finance
- Phone
- (907) 729-4939
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | NU | Primary |
Addresses
Primary practice location
4320 Diplomacy Dr
Anchorage, AK 99508-5925
Mailing address
PO Box 35198
Seattle, WA 98124-5198
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1696889 | Medicaid | AK |
Other names 2
- BH- PCC
- SUD 1115- PCC
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051027000416 | TX | Part B Supplier - Clinic/Group Practice | 5496663627 |
Receives reassigned benefits from 534 practitioners This NPI is an additional NPI on the enrollment Practice locations: Anchorage, AK; Chugiak, AK; Fairbanks, AK; Igiugig, AK; Iliamna, AK; Kockhanok, AK; McGrath, AK; Nondalton, AK… |
National Provider Directory
National Provider Directory- Tax ID family
- Southcentral Foundation Nikolai Health Center
- Part of
- Southcentral Foundation Nikolai Health Center
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.
-
- Clinic Pharmacy
- Anchorage, AK
- NPI 1467661553
-
dba Eklutna BH
- Community/Behavioral Health Agency
- Chugiak, AK
- NPI 1144830837
-
- Primary Care Clinic/Center
- Anchorage, AK
- NPI 1164669040
-
dba Care Coordination - Waiver Care Coordination
- Case Management Agency
- Anchorage, AK
- NPI 1164690459
-
dba Tribal- Fireweed
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Anchorage, AK
- NPI 1174734503
-
dba The Pathway Home Rendezvous
- Psychiatric Residential Treatment Facility
- Anchorage, AK
- NPI 1194987370
-
- General Acute Care Hospital
- Anchorage, AK
- NPI 1215128509
-
dba Intensive Home Based Treatment
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Anchorage, AK
- NPI 1215700554
-
dba Dental- Children's Dental Clinic
- General Practice Dentistry
- Anchorage, AK
- NPI 1225618481
-
dba BH 1115- Icm
- Community/Behavioral Health Agency
- Anchorage, AK
- NPI 1275186975
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Professional Counselor
- Wasilla, AK
- NPI 1801137989
-
- Psychiatry Physician
- Anchorage, AK
- NPI 1073132593
-
- Psychiatry Physician
- Traverse City, MI
- NPI 1194837336
-
- Clinical Social Worker
- Grand Junction, CO
- NPI 1336611698
-
- Psychiatry Physician
- Tamarac, FL
- NPI 1801356688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1563926400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1758758400000",
"number": "1306499710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 35198",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981245198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4320 DIPLOMACY DR",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085925",
"telephone_number": "907-729-3300"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHCENTRAL FOUNDATION",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SOUTHCENTRAL FOUNDATION",
"enumeration_date": "2019-07-24",
"last_updated": "2025-09-25",
"certification_date": "2025-09-25",
"status": "A",
"authorized_official_last_name": "OLSON",
"authorized_official_first_name": "RONALD",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT FINANCE",
"authorized_official_telephone_number": "907-729-4939"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1696889",
"state": "AK"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "BH- PCC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "SUD 1115- PCC",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Anchorage, AK
- Southcentral Foundation (SUD 1115- 4 Directions)
- Southcentral Foundation (HPG- Chap Group)
- Southcentral Foundation (BSD- FASD Clinic)
- Southcentral Foundation (BSD- Detox)
- Southcentral Foundation (BH 1115- Icm)
- Southcentral Foundation (Tribal- Centennial Center Clinic)
- Southcentral Foundation (Dental- Fireweed Dental Clinic)
- Southcentral Foundation (Pharmacy- RASU)
- Southcentral Foundation (Behavioral Health Aide Practioner Group)
- Southcentral Foundation (Dental- Dental on 36th)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.