Provider Demographics
NPI:1366045874
Name:GR&E MIND EVOLUTION ALL PURPOSE CENTER PLLC
Entity Type:Organization
Organization Name:GR&E MIND EVOLUTION ALL PURPOSE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:GINA
Authorized Official - Middle Name:RHEA
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:956-391-7919
Mailing Address - Street 1:909 BUSINESS PARK DR STE 11
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-6054
Mailing Address - Country:US
Mailing Address - Phone:956-391-7919
Mailing Address - Fax:
Practice Address - Street 1:909 BUSINESS PARK DR STE 11
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-6054
Practice Address - Country:US
Practice Address - Phone:956-391-7919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty