Provider Demographics
NPI:1295334357
Name:COAST NEW HORIZON INC.
Entity type:Organization
Organization Name:COAST NEW HORIZON INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MALIHE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAKHOURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-735-6058
Mailing Address - Street 1:824 PRESIDIO DR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5829
Mailing Address - Country:US
Mailing Address - Phone:714-668-5607
Mailing Address - Fax:714-668-1002
Practice Address - Street 1:824 PRESIDIO DR
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5829
Practice Address - Country:US
Practice Address - Phone:714-668-5607
Practice Address - Fax:714-668-1002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility