Organization
FAIRBANKS NATIVE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA FONGER (BILLING COMPLIANCE DIRECTOR)
(907) 452-6251
Entity
Organization
Contact information
Practice address
714 4TH AVE, FAIRBANKS, AK 99701-4470
(907) 452-6251
Mailing address
315 WENDELL AVE, FAIRBANKS, AK 99701-4837
(907) 452-6251
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/30/2020
Last updated
12/30/2020
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