Provider Demographics
NPI:1023378932
Name:TANANA NATIVE COUNCIL
Entity Type:Organization
Organization Name:TANANA NATIVE COUNCIL
Other - Org Name:TANANA REGIONAL ELDERS RESIDENCE
Other - Org Type:Other Name
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-366-7222
Mailing Address - Street 1:PO BOX 77130
Mailing Address - Street 2:
Mailing Address - City:TANANA
Mailing Address - State:AK
Mailing Address - Zip Code:99777-0130
Mailing Address - Country:US
Mailing Address - Phone:907-366-7213
Mailing Address - Fax:
Practice Address - Street 1:100 FRONT ST
Practice Address - Street 2:
Practice Address - City:TANANA
Practice Address - State:AK
Practice Address - Zip Code:99777-9800
Practice Address - Country:US
Practice Address - Phone:907-366-7213
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-24
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility