| Tanana Chiefs Conference | |
|
122 1st Ave Suite 600 Fairbanks AK 99701-4803 | |
| (907) 452-8251 | |
| Not Available |
| Full Name | Tanana Chiefs Conference |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 122 1st Ave, Fairbanks, Alaska |
| Authorized Official Name and Position | Jacoline Bergstrom (HS DIRECTOR) |
| Authorized Official Contact | 9074528251 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tanana Chiefs Conference 122 1st Ave Suite 600 Fairbanks AK 99701-4803 Ph: (907) 452-8251 | Tanana Chiefs Conference 122 1st Ave Suite 600 Fairbanks AK 99701-4803 Ph: (907) 452-8251 |
| NPI Number | 1447469770 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 07/24/2024 |
| Certification Date | 07/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447469770 | NPI | - | NPPES |
| MH3368 | Medicaid | AK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | 246135 (Alaska) | Secondary |
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