MEDICARE: VALLEY AIDS COUNCIL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1093032229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY AIDS COUNCIL

Provider Business Mailing Address
First Line	:	2306 CAMELOT PLAZA CIR
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78550-8984
Country	:	US
Telephone Number	:	956-428-2653
Fax Number	:	956-428-9538

Provider Business Practice Location Address
First Line	:	857 E WASHINGTON ST STE G
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-5939
Country	:	US
Telephone Number	:	956-541-2600
Fax Number	:	956-541-9202

Authorized Official
Title or Position	:	CEO
Name	:	WALLY CANTU
Credential	:
Telephone Number	:	956-428-2653

Provider Enumeration Date	:	04/28/2010
Last Update Date	:	03/27/2025

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