New Horizon Facility Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL9265 Issued in FL

Legal business name

NEW HORIZON FACILITY INC.

Doing business as

Crescent Lake House

Practice address

2301 S US Highway 17
Crescent City, FL 32112-3933

Phone

(386) 698-1444

Fax

(386) 698-2537

NPI assigned

Sep 20, 2016

Organization subpart

No

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

Authorized official

Name

Abdul Eldick

Title

President

Phone

(386) 698-1444

Specialties & licenses 1

Addresses

Other names 1

• Crescent Lake House Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565136000000",
    "number": "1548718406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 S US HIGHWAY 17",
            "city": "CRESCENT CITY",
            "state": "FL",
            "postal_code": "321123933",
            "telephone_number": "386-698-1444",
            "fax_number": "386-698-2537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 S US HIGHWAY 17",
            "city": "CRESCENT CITY",
            "state": "FL",
            "postal_code": "321123933",
            "telephone_number": "386-698-1444",
            "fax_number": "386-698-2537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HORIZON FACILITY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2019-08-07",
        "status": "A",
        "authorized_official_last_name": "ELDICK",
        "authorized_official_first_name": "ABDUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-698-1444"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL9265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crescent Lake House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leo Mancini, PTA
• Patricia Marvin, PA-CMPH
• Kristen Michaud, PHARMD
• Joanne Mullaney, RN
• Mary Katherine Murphy, WHNP/FNP-C
• Adetayo O Olayinka, B.PHARM
• Pamela J. Keller, DMD, P.a.
• Beatrice Perez, APRN
• Jonathan F Reed, PTA
• Billie Jo Revels

• Assisted Living Facility in Crescent City, FL
• Providers in Crescent City, 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 Aug 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.