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Organization
VALLEY GRANDE SCC LLC
Active
Organization
VALLEY GRANDE SCC LLC
Active
Other names
SCC at Valley Grande
Organization subpart
No
Provider details
NPI number
Authorized official
JASON PRICE (SENIOR VICE PRESIDENT)
(949) 436-4343
Entity
Organization
Contact information
Practice address
901 WILDROSE LN, BROWNSVILLE, TX 78520-8816
(956) 546-4568
(956) 546-2517
Mailing address
901 WILDROSE LN, BROWNSVILLE, TX 78520-8816
(956) 546-4568
(956) 545-2517
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001026961
—
TX
01
—
005002
VENDOR ID/FACILITY ID
TX
Enumeration date
05/22/2015
Last updated
09/04/2020
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