Organization
TANANA CHIEFS CONFERENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOLINE BERGSTROM (DIRECTOR OF HEALTH SERVICES)
(907) 452-8251
Entity
Organization
Contact information
Practice address
1717 W COWLES ST, FAIRBANKS, AK 99701-5926
(907) 451-6682
Mailing address
201 1ST AVE STE 300, FAIRBANKS, AK 99701-4848
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QX0200X
Oncology Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
372500000X
Chore Provider
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
05/08/2007
Last updated
10/06/2025
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