OrganizationActive
Southcentral Foundation
NPI 1548628555 · Mental Health Clinic/Center (Including Community Mental Health Center) · Tyonek, AK
Provider details
- NPI number
- 1548628555
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ronald Olson, Vp Finance(907) 729-4939
- License
- 20467 (AK)
Specialties & taxonomies
- Mental Health Clinic/Center (Including Community Mental Health Center)Primary261QM0801XLicense 20467 (AK)
Ambulatory Health Care Facilities
Practice location
101 Indian Creek Road
Tyonek, AK 99682
Phone: (907) 583-2461
Approximate (ZIP-level) locationGet directions
Mailing address
4501 Diplomacy Dr
Anchorage, AK 99508-5919
Other names (DBA / former)
- Doing business as
- Indian Creek Bsd Clinic
Registry dates
- Enumerated
- 2016-02-04
- Last updated
- 2016-03-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.