Sud 1115- Detox

LBN: Southcentral Foundation
Sud 1115- Detox is an health care organization with primary practice located at 4330 Elmore Rd , Anchorage AK 99508-5907. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Southcentral Foundation can be contacted via phone (907) 729-6690, or through Olson, Ronald Lee via phone (907) 729-4939.

Contact Information

Primary practice address
4330 Elmore Rd Anchorage AK 99508-5907
Phone: (907) 729-6690
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Olson, Ronald Lee
Phone: (907) 729-4939

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1750934188
LBN Legal business name Southcentral Foundation
DBA Doing business as Sud 1115- Detox
Authorized official Olson, Ronald Lee
Entity Organization
Organization subpart 1 Yes
Enumeration date Jul 24th, 2019
Last updated Sep 14th, 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 1750934188 NPPES
Alaska MEDICAID 1696899

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