TANANA CHIEFS CONFERENCE (NPI# 1770128811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770128811 |
| Entity Type | Organization |
| Organization Name | TANANA CHIEFS CONFERENCE |
| Practice Address |
West Willow and C Street Tok AK 99780 |
| Mailing Address |
122 1st Ave Ste 600 Fairbanks AK 99701-4899 |
| Practice Telephone | 9074528251 |
| Mailing Telephone | 9074528251 |
| Enumeration Date | 2019-11-13 |
| Last Update Date | 2019-11-13 |
| Authorized Official Name | JACOLINE BERGSTROM (EX. DIRECTOR OF H.S.) |
| Authorized Official Telephone | 9074528251 |
| Is Organization Subpart | Y |
| Parent Organization Name | TANANA CHIEFS CONFENERCE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Tok Behavioral Health | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447895578 | Tanana Chiefs Conference | Community/Behavioral Health | 117 1st Ave, Fairbanks, AK 99701-4802 | 2019-11-13 |
| 1497390538 | Tanana Chiefs Conference | Community/Behavioral Health | 122 1st Ave Ste 106, Fairbanks, AK 99701-4871 | 2019-11-13 |
| 1467784140 | Tanana Chiefs Conference | Community Based Residential Treatment Facility, Mental Illness | 122 First Avenue 4th Floor, Fairbanks, AK 99701 | 2010-02-05 |
| 1154565133 | Tanana Chiefs Conference | Community Based Residential Treatment Facility, Mental Illness | 122 1st Ave Ste 4, Fairbanks, AK 99701-4871 | 2009-04-22 |
| 1841835980 | Tanana Chiefs Conference | Community/Behavioral Health | 1521 S Cushman St, Fairbanks, AK 99701-6203 | 2019-11-13 |
| 1740825884 | Tanana Chiefs Conference | Community/Behavioral Health | 77 Antoski Ave, Galena, AK 99741 | 2019-11-13 |
| 1306481437 | Tanana Chiefs Conference | Community/Behavioral Health | 1717 W Cowles St, Fairbanks, AK 99701-5926 | 2019-11-13 |
| 1740531656 | Tanana Chiefs Conference | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 122 1st Ave Ste 600, Fairbanks, AK 99701-4871 | 2012-10-02 |
| 1013205608 | Tanana Chiefs Conference | Substance Abuse Rehabilitation Facility | 201 1st Ave, Fairbanks, AK 99701-4848 | 2011-07-15 |
| 1124350624 | Tanana Chiefs Conference | Community Based Residential Treatment Facility, Mental Illness | 122 1st Ave, Suite 400, Fairbanks, AK 99701 | 2010-02-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | TANANA CHIEFS CONFERENCE | 122 1st Ave Ste 600, Fairbanks, AK 99701-4871 |
| Street Address |
WEST WILLOW AND C STREET |
| City | TOK |
| State | AK |
| Zip Code | 99780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538681 | Kory Labbe | Counselor | 124 Tok Cut Off, Tok, AK 99780 | 2020-11-03 |
| 1396350633 | Tanana Chiefs Confenerce | Pharmacy | Mile 124.4 Glenn Highway, Tok, Ak, AK 99780 | 2020-09-14 |
| 1780294934 | Charmaine Shay Isaac | Counselor | Tetlin Health Clinic, Tetlin, AK 99780 | 2020-08-03 |
| 1588227920 | Joetta Lynn Thompson Colquette | Counselor | West C Street and Willow, Tok, AK 99780 | 2019-04-22 |
| 1093245144 | Mariah Craig | Community Health Worker | Mile 5.9 Mentasta Spur Road, Mentasta Lake, AK 99780 | 2017-06-12 |
| 1881070258 | Arron Atchley | Technician | 204 East Chene Way, Tok, AK 99780 | 2015-08-07 |
| 1881079705 | Francine Lee | Registered Nurse | 1314 Alaska Hwy, Tok, AK 99780 | 2015-07-21 |
| 1265856306 | Ashley Sawyer | Driver | Mp 1314 Alaska Highway, Tok, AK 99780 | 2014-02-10 |
| 1932536877 | Alberta David | Community Health Worker | 123 Tok Cut Off Road, Tok, AK 99780 | 2013-10-10 |
| 1548607211 | Stuart E Marcotte | Family Medicine | 124.5 Glenn Highway, Upper Tanana Health Center, Tok, AK 99780 | 2013-06-04 |
| Find all providers in zip 99780 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508999483 | Susan Catherine Hanson | Community/Behavioral Health | Milepost 125 Tok Cut Off, Tok, AK 99780 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700483781 | Anchorage Community Mental Health Services, Inc | Community/Behavioral Health | 704 W 26th Ave, Anchorage, AK 99503-2532 | 2020-10-03 |
| 1992314215 | Residential Youth Care, Inc. | Community/Behavioral Health | 2442 Tongass Avenue, Ketchikan, AK 99901 | 2020-07-23 |
| 1124646641 | Alaska Art Therapy and Counseling | Community/Behavioral Health | 1107 W 8th St Unit 5, Juneau, AK 99801-1853 | 2020-07-10 |
| 1316563026 | Residential Youth Care, Inc. | Community/Behavioral Health | 606 Hill Road, Ketchikan, AK 99901 | 2020-06-18 |
| 1043836851 | Residential Youth Care, Inc. | Community/Behavioral Health | 2514 1st Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1215553029 | Residential Youth Care, Inc. | Community/Behavioral Health | 2951 Baranof Avenue, Ketchikan, AK 99901 | 2020-06-18 |
| 1316561509 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1507 3rd St, Douglas, AK 99824 | 2020-06-03 |
| 1225652407 | Juneau Youth Services, Inc. | Community/Behavioral Health | 1600 Renninger St, Juneau, AK 99801 | 2020-06-03 |
| 1316561590 | Juneau Youth Services, Inc. | Community/Behavioral Health | 2901 Riverside Dr, Juneau, AK 99801 | 2020-06-03 |
| 1366066540 | Juneau Youth Services, Inc. | Community/Behavioral Health | 3400 Tongass Blvd, Juneau, AK 99801 | 2020-06-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.