Healthcare Provider Details

I. General information

NPI: 1649468950
Provider Name (Legal Business Name): PLEASANT VALLEY ENTERPRIZES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2007
Last Update Date: 10/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 E GRIFFIN PKWY SUITE B
MISSION TX
78572-3323
US

IV. Provider business mailing address

2700 E. GRIFFIN PARKWAY SUITE B
MISSION TX
78572
US

V. Phone/Fax

Practice location:
  • Phone: 956-664-2663
  • Fax: 956-994-9426
Mailing address:
  • Phone: 956-664-2663
  • Fax: 956-994-9426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number120690
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code311Z00000X
TaxonomyCustodial Care Facility
License Number120690
License Number StateTX

VIII. Authorized Official

Name: MS. SAN JUANITA PATRICIA SAENZ
Title or Position: ADMINISTRATOR
Credential:
Phone: 956-664-2663