Organization
TANANA CHIEFS CONFERENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EFFIE JUNE MOE (CAMP COUNSELOR)
(907) 452-8251
Entity
Organization
Contact information
Practice address
201 1ST AVE, FAIRBANKS, AK 99701-4848
(907) 451-8251
(907) 459-3810
Mailing address
2223 GILLAM WAY, FAIRBANKS, AK 99701-6818
(907) 452-8251
(907) 459-3810
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
3245S0500X
AK
Other
Enumeration date
07/15/2011
Last updated
07/15/2011
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