INDIAN CREEK BSD CLINIC
NPI 1548628555
Clinic/Center - Mental Health (Including Community Mental Health Center) in Tyonek, AK
About Indian Creek Bsd Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
INDIAN CREEK BSD CLINIC (NPI 1548628555) is a healthcare organization registered as a mental health (including community mental health center) in Tyonek, Alaska and active in the NPI registry since February 2016. The organization holds a CLIA Waiver certificate valid through June 22, 2028 and lists Ronald Lee Olson, Vp Finance, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 02D2346073
Indian Creek Health Clinic · Tyonek, AKOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
TYONEK, AK 99682
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Southcentral Foundation's NPI number?
The NPI number for Southcentral Foundation is 1548628555. It was assigned to this organization in the NPPES registry on February 4, 2016. The provider is doing business as Indian Creek Bsd Clinic.
Where is Southcentral Foundation located?
Southcentral Foundation is located at 101 Indian Creek Road, Tyonek, AK 99682. The listed phone number is (907) 583-2461.
What is Southcentral Foundation's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.
Does Southcentral Foundation hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 02D2346073) is associated with this NPI, valid through June 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Southcentral Foundation was last updated on March 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Indian Creek Bsd Clinic · NPI 1548628555
Mental Health (Including Community Mental Health Center) organization in Tyonek, Alaska. Organization record, active in the CMS NPPES registry since February 4, 2016.
## Identity
- **NPI:** 1548628555 (Entity type: Organization)
- **Enumerated:** February 4, 2016
- **Primary specialty:** Clinic/Center - Mental Health (Including Community Mental Health Center) · taxonomy 261QM0801X
- **Legal business name:** Southcentral Foundation
- **Organization subpart:** No
- **Authorized official:** Ronald Olson, VP FINANCE
## Practice location
- **Address:** 101 INDIAN CREEK ROAD, Tyonek, AK 99682
- **Phone:** (907) 583-2461
## Record status
- **NPPES last updated:** March 15, 2016
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1548628555) · Data from the CMS NPPES public registry.