Organization
SEVENTY-SEVEN HOUSE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PABLE LOPEZ DELEON (OWNER/DIRECTOR)
(561) 373-8656
Entity
Organization
Contact information
Practice address
183 JOG RD, WEST PALM BCH, FL 33415-2343
(561) 373-8656
Mailing address
183 JOG RD, WEST PALM BCH, FL 33415-2343
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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