Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Scg Lake Country LLC

Organization Skilled Nursing Facility · NPI 1033110457

Scg Lake Country LLC is a Skilled Nursing Facility in Marietta, Oklahoma. Licensed in Oklahoma. Registered with an NPI since 2005.

Licensed in
OK
In the registry since
2005
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

401 C E Colston Dr
Marietta, OK 73448-1230
Phone: (580) 276-3318
Fax: (580) 276-2100
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence NH4301-4301 (OK)

Record details

NPI number1033110457
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Robert Vaughan — President · (813) 341-2700
Other names Lake Country Nursing Center
NPI enumeratedAugust 9, 2005
Last updated in NPPESJanuary 22, 2010
Mailing address1240 Marbella Plaza Dr., Tampa, FL 33619-7905

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