# VALLEY GRANDE SCC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SCC at Valley Grande
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194104190
- **Authorized official:** JASON PRICE (SENIOR VICE PRESIDENT)
- **Authorized official phone:** (949) 436-4343

## Contact information

- **Practice address:** 901 WILDROSE LN, BROWNSVILLE, TX 78520-8816
- **Practice address phone:** (956) 546-4568
- **Practice address fax:** (956) 546-2517
- **Mailing address:** 901 WILDROSE LN, BROWNSVILLE, TX 78520-8816
- **Mailing address phone:** (956) 546-4568
- **Mailing address fax:** (956) 545-2517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | TX | Yes |

## Other

- **Enumeration date:** 05/22/2015
- **Last updated:** 09/04/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001026961 | — | TX |
| 01 | — | 005002 | VENDOR ID/FACILITY ID | TX |