SEVENTY-SEVEN HOUSE (NPI# 1356689822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356689822 |
| Entity Type | Organization |
| Organization Name | SEVENTY-SEVEN HOUSE |
| Practice Address |
183 Jog Rd West Palm Bch FL 33415-2343 |
| Practice Telephone | 5613738656 |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-01-17 |
| Authorized Official Name | MR. PABLE LOPEZ DELEON (OWNER/DIRECTOR) |
| Authorized Official Telephone | 5613738656 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities |
| Street Address |
183 JOG RD |
| City | WEST PALM BCH |
| State | FL |
| Zip Code | 33415-2343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326670613 | Briana Howard | Social Worker | 631-sea Pine Way F2, Greenacres, FL 33415 | 2020-02-05 |
| 1023648821 | Belen Home Care | Assisted Living Facility | 4584 Sutton Terra South, West Palm Beach, FL 33415 | 2020-01-21 |
| 1013556315 | Titan Chiropractic & Rehab | Chiropractor | 655 N Military Trail Ste 9, West Palm Beach, FL 33415 | 2020-01-03 |
| 1467006916 | Bradley Martin | Student in an Organized Health Care Education/Training Program | 5189 Pine Abbey Drive South, West Palm Beach, FL 33415 | 2019-08-01 |
| 1508370131 | Lisa Palmieri | Physical Therapist | 5056 Wallis Rd, West Palm Beach, FL 33415 | 2017-11-17 |
| 1093233637 | Anay Piloto Garcia | Behavior Technician | 1851 W Chatham Rd, West Palm Beach, FL 33415 | 2017-09-05 |
| 1356897631 | Leida C Alarcon | Technician, Other | 2221 White Pine Cir Apt D, Greenacres, FL 33415 | 2016-08-28 |
| 1689061996 | Antonio Cruz | Physical Therapy Assistant | 2939 S Haverhill Road, Wpb, FL 33415 | 2015-04-24 |
| 1780019034 | Michele Thune | Nurse Practitioner | 942 Scott Dr, West Palm Beach, FL 33415 | 2013-09-05 |
| 1780017657 | Genesis Rehab Services | Skilled Nursing Facility | 6414 13th Rd. South, Woodlake, West Palm Beach, FL 33415 | 2013-08-15 |
| Find all providers in zip 33415 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366040354 | Jaime E Hatch | Assisted Living Facility | 86374 Peeples Rd, Yulee, FL 32097-3387 | 2020-10-13 |
| 1730711219 | North Florida Senior Living LLC | Assisted Living Facility | 541103 Lem Turner Rd, Callahan, FL 32011-8546 | 2020-02-12 |
| 1144860206 | Iconnect Jax | Assisted Living Facility | 4372 Southside Blvd Ste 203, Jacksonville, FL 32216-8503 | 2020-01-07 |
| 1013495175 | Sunshine Assisted Living Home Care Facility. | Assisted Living Facility | 1422 Se 23rd Ter., Crape Coral, FL 33990 | 2018-08-01 |
| 1790276905 | Villa Rosa Iv, Inc. | Assisted Living Facility | 3051 E. 4 Avenue, Hialeah, FL 33013 | 2018-05-23 |
| 1679062814 | Interdisciplinary Healthcare Services LLC | Assisted Living Facility | 12751 Sw 226 Street, Miami, FL 33170 | 2018-05-03 |
| 1104368240 | Jermaine Jordan | Assisted Living Facility | 1210 Retreat View Cir, Sanford, FL 32771-7276 | 2016-11-07 |
| 1346617412 | Louise Irving | Assisted Living Facility | 4561 Sw 36th St, West Park, FL 33023-5511 | 2015-08-25 |
| 1821473000 | A-1 Medical and Behavioral Management Svc | Assisted Living Facility | 2822 54th Ave S, # 215, St Petersburg, FL 33712-4610 | 2015-07-29 |
| 1730574906 | Jordico LLC | Assisted Living Facility | 4417 13th Street, Suite 142, Saint Cloud, FL 34769 | 2015-04-03 |
| Find all providers with the same taxonomy | ||||
| City | WEST PALM BCH |
| Zip Code | 33415 |
Please comment or provide details below to improve the information on SEVENTY-SEVEN HOUSE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.