Southcentral Foundation

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SOUTHCENTRAL FOUNDATION

Doing business as

Tribal/HPG- ICM (Intensive Case Management)

Practice address

400 W Benson Blvd
Anchorage, AK 99503-3829

Phone

(907) 729-2500

NPI assigned

Feb 18, 2021

Last updated

Sep 14, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

SOUTHCENTRAL FOUNDATIONAs reported in NPPES

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

Addresses

Other identifiers 2

Other names 1

• Tribal/HPG- ICM (Intensive Case Management) Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Part of

Southcentral Foundation Nikolai Health Center

Practitioners 1

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.

• Bahiyyih Alexandra Young, LPC

  • Counselor
  • Anchorage, AK
  • NPI 1124577499
  NPD

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1780277830",
    "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": "400 W BENSON BLVD",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995033829",
            "telephone_number": "907-729-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHCENTRAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHCENTRAL FOUNDATION",
        "enumeration_date": "2021-02-18",
        "last_updated": "2023-09-14",
        "certification_date": "2023-07-11",
        "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": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730741",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1733640",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tribal/HPG- ICM (Intensive Case Management)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southcentral Foundation (BSD- Behavioral Health Trails)
• Southcentral Foundation (Tribal- KKGB CFDS)
• Southcentral Foundation
• Southcentral Foundation (BSD-Icm)
• Southcentral Foundation (SUD 1115- Detox)
• Southcentral Foundation
• Southcentral Foundation (Igiugig BSD Clinic)
• Southcentral Foundation
• Southcentral Foundation (Tribal- Brother Francis Shelter)
• Southcentral Foundation (BH 1115- Quyana Clubhouse)

• Multi-Specialty Clinic/Center in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Multi-Specialty Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.

Verify at the official NPI Registry.