Organization
SENIOR CARE GROUP OF YANCEY LLC
Active
Other names
Brockside Rehabilitation and Care
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DANIEL VAUGHAN (PRESIDENT)
(813) 341-2700
Entity
Organization
Contact information
Practice address
310 PENSACOLA RD, BURNSVILLE, NC 28714-3318
(828) 682-9759
(828) 682-4096
Mailing address
1240 MARBELLA PLAZA DR, TAMPA, FL 33619-7906
(813) 341-2700
(813) 676-0126
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH0467
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3415305
—
NC
Enumeration date
12/01/2005
Last updated
12/23/2009
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