Organization
OLD MINTO FAMILY RECOVERY CAMP
Active
Parent organization
TANANA CHIEFS CONFERENCE
Organization subpart
Yes
Provider details
NPI number
Legal business name
TANANA CHIEFS CONFERENCE
Authorized official
VICTOR JOSEPH (HEALTH SERVICES DIRECTOR)
(907) 452-8251
Entity
Organization
Contact information
Practice address
122 1ST AVE, FAIRBANKS, AK 99701-4803
(907) 452-8251
Mailing address
122 1ST AVE, FAIRBANKS, AK 99701-4803
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
246135
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DA4380
—
AK
Enumeration date
04/08/2008
Last updated
04/08/2008
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