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General NPI Number Information
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NPI Number | 1376759381
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Entity Type | Organization
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Legal Business Name | VALLEY RESIDENTIAL CORP
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Dates
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Enumeration Date | 05/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 8 CASA LINDA
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City | BROWNSVILLE
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State | TX
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Zip | 78521-2734
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Country | US
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Telephone | 956-504-6019
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Fax | 956-504-6019
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Provider Business Mailing Address
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Address Line | 8 CASA LINDA
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City | BROWNSVILLE
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State | TX
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Zip | 78521-2734
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Country | US
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Telephone | 956-504-6019
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Fax | 956-504-6019
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Authorized Official
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Title or Position | C.E.O.
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Name | MRS. TAMARA LYNN ALLEN-BRAY
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Credential |
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Telephone | 956-547-9983
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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