| Neuro Focus Center Llc | |
|
1400 North Gilbert Road Suite H Gilbert AZ 85234-2726 | |
| (480) 632-2301 | |
| (480) 813-4534 |
| Full Name | Neuro Focus Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1400 North Gilbert Road, Gilbert, Arizona |
| Authorized Official Name and Position | Waldeck Charles (CEO) |
| Authorized Official Contact | 6023157033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neuro Focus Center Llc 1400 North Gilbert Road Suite H Gilbert AZ 85234-2726 Ph: (480) 632-2301 | Neuro Focus Center Llc 1400 North Gilbert Road Suite H Gilbert AZ 85234-2726 Ph: (480) 632-2301 |
| NPI Number | 1790075208 |
|---|---|
| Provider Enumeration Date | 04/18/2011 |
| Last Update Date | 04/02/2012 |
| Medicare PECOS PAC ID | 2466629993 |
|---|---|
| Medicare Enrollment ID | O20120124000323 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790075208 | NPI | - | NPPES |
| 611096 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 33521 (Arizona) | Primary |
| Provider Name | Waldeck Charles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689752123 PECOS PAC ID: 9436101060 Enrollment ID: I20050211000422 |
| Provider Name | Moise Joseph |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942420419 PECOS PAC ID: 4486693116 Enrollment ID: I20050502000681 |
| Provider Name | Maja Michelle Everson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811975139 PECOS PAC ID: 7618961475 Enrollment ID: I20101007000673 |
| Provider Name | Elizabeth A Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912910472 PECOS PAC ID: 8921064106 Enrollment ID: I20120125000489 |
| Provider Name | Nirva Jean-baptiste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407279771 PECOS PAC ID: 3577887553 Enrollment ID: I20150122000480 |
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