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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