| NPI | 1750702122 |
|---|---|
| Doing Business As | SEVENTY SEVEN RECOVERY |
| Entity Type | Organization |
| Authorized Contact | PABLO ARNULFO LOPEZ DE LEON CEO 561-355-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: FL 1550AD183801) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2014-01-02 |