NPIMap

Organization Active NPI

Tanana Chiefs Conference

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Fairbanks, AK
National Provider Identifier
1043469349
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
TANANA CHIEFS CONFERENCE
Practice address
122 1St Ave
Suite 600 Client Development
Fairbanks, AK 99701-4803
Phone
(907) 452-8251
Fax
(907) 459-3883
NPI assigned
Sep 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Jacoline Bergstrom
Title
Health Director
Phone
(907) 452-8251

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X

Addresses

Primary practice location

122 1St Ave
Suite 600 Client Development
Fairbanks, AK 99701-4803

Mailing address

122 1St Ave
Suite 600 Client Development
Fairbanks, AK 99701-4803
Phone (907) 452-8251

Other identifiers 2

IdentifierTypeStateIssuer
CMG438MedicaidAK
HC2438MedicaidAK

National Provider Directory

National Provider Directory
Tax ID family
Tanana Chiefscon38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1043469349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 1ST AVE",
            "address_2": "SUITE 600 CLIENT DEVELOPMENT",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014803",
            "telephone_number": "907-452-8251",
            "fax_number": "907-459-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 1ST AVE",
            "address_2": "SUITE 600 CLIENT DEVELOPMENT",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014803",
            "telephone_number": "907-452-8251",
            "fax_number": "907-459-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANANA CHIEFS CONFERENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-11",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "BERGSTROM",
        "authorized_official_first_name": "JACOLINE",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "907-452-8251",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CMG438",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HC2438",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.