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Organization

SCG LAURELLWOOD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARK D KRAMER (CEO)
(813) 341-2700
Entity
Organization

Contact information

Practice address
3127 57TH AVE N, ST PETERSBURG, FL 33714-1320
(727) 527-2171
(727) 522-6929
Mailing address
3127 57TH AVE N, ST PETERSBURG, FL 33714-1320
(727) 527-2171
(727) 522-6929

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
SNF11790962
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SNF11790962
STATE LICENSE NUMBER
FL
Enumeration date
10/04/2005
Last updated
07/31/2008
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