NPIMap

Organization Active NPI

Tanana Chiefs Conference

  • Substance Abuse Rehabilitation Facility
  • Fairbanks, AK
National Provider Identifier
1063290955
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
TANANA CHIEFS CONFERENCE
Doing business as
Tanana Chiefs Conference
Practice address
2550 Lawlor Rd
Fairbanks, AK 99709-6458
Phone
(907) 452-8251
Fax
(907) 459-3860
NPI assigned
Sep 20, 2023
Last updated
Apr 25, 2025By the provider in NPPES
Organization subpart
No

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
TCC Health Director
Phone
(907) 452-8251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X NU Primary

Addresses

Primary practice location

2550 Lawlor Rd
Fairbanks, AK 99709-6458

Mailing address

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

Other names 1

  • Tanana Chiefs Conference Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Old Minto Family Recovery Camp38 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": "1695168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1063290955",
    "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",
            "fax_number": "907-459-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 LAWLOR RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997096458",
            "telephone_number": "907-452-8251",
            "fax_number": "907-459-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANANA CHIEFS CONFERENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-20",
        "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": "TCC HEALTH DIRECTOR",
        "authorized_official_telephone_number": "907-452-8251"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tanana Chiefs Conference",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tanana Chiefs Conference",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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.