Bh 1115- Quyana Clubhouse

LBN: Southcentral Foundation
Bh 1115- 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 Agencies / Community/Behavioral Health, 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
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1821691254
LBN Legal business name Southcentral Foundation
DBA Doing business as Bh 1115- Quyana Clubhouse
Authorized official Olson, Ronald Lee
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 18th, 2020
Last updated Sep 15th, 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 1821691254 NPPES
Alaska MEDICAID 1714246

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