Provider Demographics
NPI:1912591462
Name:CENTRAL NERVOUS SYSTEM CENTER, PLLC
Entity Type:Organization
Organization Name:CENTRAL NERVOUS SYSTEM CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-367-1500
Mailing Address - Street 1:11333 N SCOTTSDALE RD STE 260
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5194
Mailing Address - Country:US
Mailing Address - Phone:480-367-1500
Mailing Address - Fax:480-367-1501
Practice Address - Street 1:11333 N SCOTTSDALE RD STE 260
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5194
Practice Address - Country:US
Practice Address - Phone:480-367-1500
Practice Address - Fax:480-367-1501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty