# VALLEY GRANDE MANOR INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1689783425
- **Authorized official:** MR. RICHARD MARTIN (PRESIDENT/OWNER)
- **Authorized official phone:** (956) 546-4568

## 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) 546-2517

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 115965 | TX | Yes |

## Other

- **Enumeration date:** 08/29/2006
- **Last updated:** 09/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000500206 | — | TX |