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Organization

TANANA CHIEFS CONFERENCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JACOLINE BERGSTROM (HS DIRECTOR)
(907) 452-8251
Entity
Organization

Contact information

Practice address
122 1ST AVE, SUITE 600, FAIRBANKS, AK 99701-4803
(907) 452-8251
Mailing address
122 1ST AVE, SUITE 600, FAIRBANKS, AK 99701-4803
(907) 452-8251

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
261QU0200X
Urgent Care Clinic/Center
246135
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MH3368
AK
Enumeration date
05/22/2007
Last updated
07/24/2024
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