NPIMap

Organization Active NPI

Tanana Chiefs Confenerce

  • Community/Behavioral Health Agency
  • Fairbanks, AK
National Provider Identifier
1053955674
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
TANANA CHIEFS CONFENERCE
Practice address
1300 Moore St
Fairbanks, AK 99701-5761
Phone
(907) 452-8251
NPI assigned
Nov 6, 2019
Organization subpart
Yes
Parent organization
TANANA CHIEFS CONFENERCEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

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

Authorized official

Name
Jacoline Bergstrom
Title
Ex. Director of H.S.
Phone
(907) 452-8251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

1300 Moore St
Fairbanks, AK 99701-5761

Mailing address

122 1St Ave Ste 106
Fairbanks, AK 99701-4871
Phone (907) 452-8251

Other names 1

  • Sobering Center Other name

National Provider Directory

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

Other organizations with this tax ID 37

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

View all 37

Locations

122 1st Ave
Ste 106
Fairbanks, AK 99701

NPI Registry JSON

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1053955674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 1ST AVE STE 106",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014871",
            "telephone_number": "907-452-8251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 MOORE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997015761",
            "telephone_number": "907-452-8251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANANA CHIEFS CONFENERCE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TANANA CHIEFS CONFENERCE",
        "enumeration_date": "2019-11-06",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A",
        "authorized_official_last_name": "BERGSTROM",
        "authorized_official_first_name": "JACOLINE",
        "authorized_official_title_or_position": "EX. DIRECTOR OF H.S.",
        "authorized_official_telephone_number": "907-452-8251"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sobering Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sobering Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 25, 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.