Provider Demographics
NPI:1114651288
Name:ROSE QUARTZ THERAPY LLC
Entity Type:Organization
Organization Name:ROSE QUARTZ THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC ASSOCIATE
Authorized Official - Prefix:MS
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:NORETTE
Authorized Official - Last Name:RUIZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC ASSOCIATE
Authorized Official - Phone:956-862-0455
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:LA JOYA
Mailing Address - State:TX
Mailing Address - Zip Code:78560-0082
Mailing Address - Country:US
Mailing Address - Phone:956-452-0168
Mailing Address - Fax:
Practice Address - Street 1:220 W 10TH ST
Practice Address - Street 2:
Practice Address - City:LA JOYA
Practice Address - State:TX
Practice Address - Zip Code:78560-9051
Practice Address - Country:US
Practice Address - Phone:956-452-0168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health