SCG Coral Landing, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SCG CORAL LANDING, LLC

Doing business as

Coral Landing Assisted Landing Residences

Practice address

2820 Old Moultrie Rd
St Augustine, FL 32086-5454

Phone

(904) 794-2273

Fax

(904) 794-2267

NPI assigned

Feb 27, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Robert Daniel Vaughan

Title

Director of Operations

Phone

(770) 255-1810

Specialties & licenses 1

Addresses

Other names 1

• Coral Landing Assisted Landing Residences Doing business as

Tax ID family

Coral Landing Assisted Landing Residences2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• SCG Coral Landing, LLC

  • Assisted Living Facility
  • St Augustine, FL
  • NPI 1821283672
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023145380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 NORCROSS ST",
            "address_2": "SUITE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "330753864",
            "telephone_number": "770-255-1810",
            "fax_number": "770-255-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 OLD MOULTRIE RD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865454",
            "telephone_number": "904-794-2273",
            "fax_number": "904-794-2267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCG CORAL LANDING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAUGHAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "770-255-1810",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coral Landing Assisted Landing Residences",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Frances Valerie Saxenberg, LCSW
• Tyler David Scarborough, PHARMD
• Jacob Scarbrough
• Kara Scarbrough, LCSW-C
• Josette Scarpa
• SCG Coral Landing, LLC
• SCG Palazzo Operator, LLC (Palazzo Di Oro)
• Hannah Schaper
• Rachel Schatzberg
• Lynnsie Schebell

• Assisted Living Facility in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.