MEDICARE: SEPPALA CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility	TBD	FL

General Provider Information

NPI Number	:	1285024067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEPPALA CORP

Provider Business Mailing Address
First Line	:	2200 FLORIDA MANGO RD STE 100
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6448
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 FLORIDA MANGO RD STE 100
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6448
Country	:	US
Telephone Number	:	561-313-4562
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHI M SEPPALA
Credential	:
Telephone Number	:	561-313-4562

Provider Enumeration Date	:	01/30/2015
Last Update Date	:	01/19/2016

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Directions to “SEPPALA CORP ” Practice Location

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