| Native Interactive Community Enrichment Llc | |
|
12223 E Cloud Rd Chandler AZ 85249-3424 | |
| (602) 290-3656 | |
| Not Available |
| Full Name | Native Interactive Community Enrichment Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12223 E Cloud Rd, Chandler, Arizona |
| Authorized Official Name and Position | Troy Truvillion (OWNER) |
| Authorized Official Contact | 6022903656 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Native Interactive Community Enrichment Llc P.o. Box 12901 Chandler AZ 85248 Ph: () - | Native Interactive Community Enrichment Llc 12223 E Cloud Rd Chandler AZ 85249-3424 Ph: (602) 290-3656 |
| NPI Number | 1053902148 |
|---|---|
| Provider Enumeration Date | 02/01/2021 |
| Last Update Date | 02/01/2021 |
| Certification Date | 01/31/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053902148 | NPI | - | NPPES |
| L20736410 | Other | AZ | ENTITY ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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