Tribal- Quyana Clubhouse

LBN: Southcentral Foundation
Tribal- Quyana Clubhouse is an health care organization with primary practice located at 225 Eagle St , Anchorage AK 99501-2626. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Southcentral Foundation can be contacted via phone (907) 729-6550, or through Olson, Ronald Lee via phone (907) 729-4939.

Contact Information

Primary practice address
225 Eagle St Anchorage AK 99501-2626
Phone: (907) 729-6550
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Olson, Ronald Lee
Phone: (907) 729-4939

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 20467 Alaska

Profile Details

NPI number 1447512660
LBN Legal business name Southcentral Foundation
DBA Doing business as Tribal- Quyana Clubhouse
Authorized official Olson, Ronald Lee
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 13th, 2012
Last updated Sep 13th, 2023 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447512660 NPPES
Alaska MEDICAID 1000855

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