Organization
SCG HARBOURWOOD LLC
Active
Other names
HarbourWood Health and Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DANIEL VAUGHAN (PRESIDENT)
(813) 341-2700
Entity
Organization
Contact information
Practice address
2855 GULF TO BAY BLVD, BLDG #31, CLEARWATER, FL 33759-4087
(727) 724-6800
(727) 724-6848
Mailing address
1240 MARBELLA PLAZA DR, TAMPA, FL 33619
(813) 341-2700
(813) 341-2755
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031663600
—
FL
01
—
M3K
BLUE CROSS AND BLUE SHIELD
FL
Enumeration date
08/16/2005
Last updated
02/07/2011
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