SEVENTY SEVEN RECOVERY INC
Ambulatory Health at 11 St, West Palm Beach, FL

License number
Florida 1550AD183801
Category
Ambulatory Health
Type
Rehabilitation, Substance Use Disorder
Owner
Name: MR. PABLO ARNULFO LOPEZ DE LEON
Title: CEO
Phone: (561) 355-1223
Address
Address
315 11Th St, West Palm Beach, FL 33401
National Provider ID: 1750702122
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SEVENTY SEVEN RECOVERY INC

West Palm Beach, FL

Status:
Inactive
Doing business as:
Seventy Seven Recover
Inactive reason:
AMENDMENT
Registration:
May 9, 2013
Inactive since:
Aug 7, 2013
Phone:
(561) 835-0534 (Phone)
Addresses:
315 11 St, West Palm Beach, FL 33401 (Physical)
100 S Dixie Hwy, West Palm Beach, FL 33401
480 Hibiscus St, West Palm Beach, FL 33401
State ID:
P13000041864
Business type:
Florida Profit Corporation
Presidents:
Pablo A Lopez Leon, 315 11 St, West Palm Beach, FL 33401 (Physical),Pablo A Lopez De Leon (President)
Agent:
The Lion Corporation,1209 N Olive Ave, West Palm Beach, FL 33401 (Physical)
EIN:
46-2881838

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