Organization
SCG BAYWOOD LLC
Active
Other names
BayWood Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT DANIEL VAUGHAN (PRESIDENT)
(813) 341-2700
Entity
Organization
Contact information
Practice address
2000 17TH AVE S, ST PETERSBURG, FL 33712
(727) 821-3544
(727) 821-0414
Mailing address
1240 MARBELLA PLAZA DR, TAMPA, FL 33619-7906
(813) 341-2700
(813) 341-2755
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH2788
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
031665200
—
FL
Enumeration date
08/10/2005
Last updated
02/07/2011
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