Organization
NATIVE INTERACTIVE COMMUNITY ENRICHMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TROY TRUVILLION (OWNER)
(602) 290-3656
Entity
Organization
Contact information
Practice address
12223 E CLOUD RD, CHANDLER, AZ 85249-3424
(602) 290-3656
Mailing address
P.O. BOX 12901, CHANDLER, AZ 85248
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L20736410
ENTITY ID
AZ
Enumeration date
02/01/2021
Last updated
02/01/2021
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