| NPI | 1073781373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTO NEGRON Owner 208-323-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M7994) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2023-08-30 |