Provider Demographics
NPI:1346314895
Name:VALLEY ASSOCIATION FOR INDEPENDENT LIVING
Entity Type:Organization
Organization Name:VALLEY ASSOCIATION FOR INDEPENDENT LIVING
Other - Org Name:VAIL
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WOODROW
Authorized Official - Middle Name:W
Authorized Official - Last Name:JOHNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:BACHELOR BUS ADMIN
Authorized Official - Phone:956-668-8245
Mailing Address - Street 1:3016 N MCCOLL RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-5564
Mailing Address - Country:US
Mailing Address - Phone:956-668-8245
Mailing Address - Fax:956-631-7296
Practice Address - Street 1:3016 N MCCOLL RD
Practice Address - Street 2:SUITE B
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-5564
Practice Address - Country:US
Practice Address - Phone:956-668-8245
Practice Address - Fax:956-631-7296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management