Provider Demographics
NPI:1003854456
Name:RIO GRANDE RESIDENT CARE INC
Entity Type:Organization
Organization Name:RIO GRANDE RESIDENT CARE INC
Other - Org Name:TWINBROOKE SOUTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:F
Authorized Official - Last Name:LUEG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-682-6101
Mailing Address - Street 1:1000 N MCCOLL RD
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-9227
Mailing Address - Country:US
Mailing Address - Phone:956-682-6101
Mailing Address - Fax:956-682-0109
Practice Address - Street 1:1000 N MCCOLL RD
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-9227
Practice Address - Country:US
Practice Address - Phone:956-682-6101
Practice Address - Fax:956-682-0109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111126311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility