Cresta Comfort Living Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL11445 Issued in FL

Legal business name

CRESTA COMFORT LIVING INC

Practice address

18610 NW 21St Ave
Miami Gardens, FL 33056-2704

Phone

(305) 624-5969

Fax

(305) 623-8859

NPI assigned

Feb 25, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Junie V Horne

Title

Administrator/Owner

Phone

(305) 624-5969

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1235520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235520000000",
    "number": "1295975647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18610 NW 21ST AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330562704",
            "telephone_number": "305-624-5969",
            "fax_number": "305-623-8859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18610 NW 21ST AVE",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "330562704",
            "telephone_number": "305-624-5969",
            "fax_number": "305-623-8859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTA COMFORT LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-25",
        "last_updated": "2009-02-25",
        "status": "A",
        "authorized_official_last_name": "HORNE",
        "authorized_official_first_name": "JUNIE",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "305-624-5969"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000463300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Miami Gardens, FL
• Providers in Miami Gardens, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.