Provider Demographics
NPI:1194502674
Name:NEUROSALUD WELLNESS PLLC
Entity type:Organization
Organization Name:NEUROSALUD WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OBREGON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:252-258-4143
Mailing Address - Street 1:1913 E FIRE TOWER RD STE J
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-4127
Mailing Address - Country:US
Mailing Address - Phone:252-258-4143
Mailing Address - Fax:
Practice Address - Street 1:1913 E FIRE TOWER RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-4126
Practice Address - Country:US
Practice Address - Phone:252-375-4380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty