Provider Demographics
NPI:1437143906
Name:SENIOR CARE GROUP, INC.
Entity Type:Organization
Organization Name:SENIOR CARE GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-341-2700
Mailing Address - Street 1:16002 LAKESHORE VILLA DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1367
Mailing Address - Country:US
Mailing Address - Phone:813-968-5093
Mailing Address - Fax:813-264-0476
Practice Address - Street 1:16002 LAKESHORE VILLA DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1367
Practice Address - Country:US
Practice Address - Phone:813-968-5093
Practice Address - Fax:813-264-0476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-09
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1282096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility