Quyana Club House Mental Health Clinic

LBN: Southcentral Foundation
Quyana Club House Mental Health Clinic 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 / Rehabilitation, 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 / Rehabilitation 261QR0400X 20467 Alaska

Profile Details

NPI number 1144274986
LBN Legal business name Southcentral Foundation
DBA Doing business as Quyana Club House Mental Health Clinic
Authorized official Olson, Ronald Lee
Entity Organization
Organization subpart 1 Yes
Enumeration date May 19th, 2006
Last updated Aug 31st, 2023 - about 3 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 1144274986 NPPES
Alaska MEDICAID 1000855
Alaska MEDICAID 1021095

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