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Southcentral Foundation — NPI 1548628555, Tyonek, AK | NPI Central

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NPI 1548628555

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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

More AK providers

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.