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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