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Organization
SCG DURANT FOUR SEASONS LLC
Active
Organization
SCG DURANT FOUR SEASONS LLC
Active
Other names
Four Seasons Nursing Center of Durant
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DANIEL VAUGHAN (PRESIDENT)
(813) 341-2700
Entity
Organization
Contact information
Practice address
1212 FOUR SEASONS DR, DURANT, OK 74701-2430
(580) 924-5300
(580) 924-1302
Mailing address
1240 MARBELLA PLAZA DR., TAMPA, FL 33619-7905
(813) 341-2700
(813) 676-0127
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0704-0704
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100769540A
—
OK
Enumeration date
10/14/2005
Last updated
01/22/2010
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