Provider Demographics
NPI:1649468950
Name:PLEASANT VALLEY ENTERPRIZES INC.
Entity type:Organization
Organization Name:PLEASANT VALLEY ENTERPRIZES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SAN JUANITA
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:SAENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-664-2663
Mailing Address - Street 1:2700 E. GRIFFIN PARKWAY
Mailing Address - Street 2:SUITE B
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572
Mailing Address - Country:US
Mailing Address - Phone:956-664-2663
Mailing Address - Fax:956-994-9426
Practice Address - Street 1:2700 E GRIFFIN PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-3323
Practice Address - Country:US
Practice Address - Phone:956-664-2663
Practice Address - Fax:956-994-9426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX120690311ZA0620X, 311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTX-108-6019OtherSPECIAL NUTRUTION PROGRAM