Valley Grande Manor Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

115965 Issued in TX

Legal business name

VALLEY GRANDE MANOR INC

Practice address

901 Wildrose LN
Brownsville, TX 78520-8816

Phone

(956) 546-4568

Fax

(956) 546-2517

NPI assigned

Aug 29, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Richard Martin

Title

President/Owner

Phone

(956) 546-4568

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222041600000",
    "number": "1689783425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WILDROSE LN",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785208816",
            "telephone_number": "956-546-4568",
            "fax_number": "956-546-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WILDROSE LN",
            "city": "BROWNSVILLE",
            "state": "TX",
            "postal_code": "785208816",
            "telephone_number": "956-546-4568",
            "fax_number": "956-546-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY GRANDE MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2008-09-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "956-546-4568",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "115965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000500206",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Brownsville, TX
• Providers in Brownsville, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.