NPIMap

Organization Active NPI

Southcentral Foundation

Doing business as Lifehouse BH

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Sutton, AK
National Provider Identifier
1407466204
Registry record updated Aug 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
SOUTHCENTRAL FOUNDATION
Doing business as
Lifehouse BH
Practice address
11495 N Callison St
Sutton, AK 99674
Phone
(907) 745-0704
Fax
(907) 729-8607
NPI assigned
Aug 6, 2020
Last updated
Aug 6, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2020

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
(701) 729-4939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

11495 N Callison St
Sutton, AK 99674

Mailing address

7033 E Tudor Rd
Anchorage, AK 99507-1262
Phone (907) 729-5418

Other names 1

  • Lifehouse BH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southcentral Foundation PDN103 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": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596672000000",
    "number": "1407466204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7033 E TUDOR RD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995071262",
            "telephone_number": "907-729-5418",
            "fax_number": "907-729-8607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11495 N CALLISON ST",
            "city": "SUTTON",
            "state": "AK",
            "postal_code": "99674",
            "telephone_number": "907-745-0704",
            "fax_number": "907-729-8607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCENTRAL FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2020-08-06",
        "certification_date": "2020-08-06",
        "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": "701-729-4939"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lifehouse BH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sutton, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2020; 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.