Provider Demographics
NPI:1235312380
Name:TANANA CHIEFS CONFERENCE
Entity Type:Organization
Organization Name:TANANA CHIEFS CONFERENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:(NMI)
Authorized Official - Last Name:ISAAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:907-452-8251
Mailing Address - Street 1:122 1ST AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-4803
Mailing Address - Country:US
Mailing Address - Phone:907-452-8251
Mailing Address - Fax:907-459-3810
Practice Address - Street 1:122 1ST AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4803
Practice Address - Country:US
Practice Address - Phone:907-452-8251
Practice Address - Fax:907-459-3810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health