| NPI | 1790065456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRVING A LUGO Owner 336-288-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NC 30835) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2014-09-11 |