Organization
VALLEY GRANDE MANOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD MARTIN (PRESIDENT/OWNER)
(956) 546-4568
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) 546-2517
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
115965
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000500206
—
TX
Enumeration date
08/29/2006
Last updated
09/22/2008
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