Healthcare Provider Details

I. General information

NPI: 1073717047
Provider Name (Legal Business Name): TANANA CHIEFS CONFENERCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2007
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 1ST AVE
FAIRBANKS AK
99701-4848
US

IV. Provider business mailing address

201 1ST AVE
FAIRBANKS AK
99701-4848
US

V. Phone/Fax

Practice location:
  • Phone: 907-452-8251
  • Fax: 907-459-3852
Mailing address:
  • Phone: 907-452-8251
  • Fax: 907-459-3852

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL OSTBLOOM
Title or Position: HOME CARE MANAGER
Credential:
Phone: 907-452-8251