Coastal Community Senior Living Services LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COASTAL COMMUNITY SENIOR LIVING SERVICES LLC

Practice address

3755 Main St Unit 101
College Park, GA 30337-3543

Phone

(844) 690-4494

Fax

(855) 538-9242

NPI assigned

Sep 10, 2026

Organization subpart

No

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

Authorized official

Name

Novella Tascoe

Title

Owner

Phone

(844) 690-4494

Specialties & licenses 1

Addresses

Other names 1

• HIYH Doing business as

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1194635185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 MAIN ST UNIT 101",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303373543",
            "telephone_number": "844-690-4494",
            "fax_number": "855-538-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3755 MAIN ST UNIT 101",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303373543",
            "telephone_number": "844-690-4494",
            "fax_number": "855-538-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL COMMUNITY SENIOR LIVING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "TASCOE",
        "authorized_official_first_name": "NOVELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "844-690-4494"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HIYH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anthony Chukwukelue, NP
• Citrine Therapy Source
• Cityviewhealthcare
• CJR Special Transportation LLC
• Clayton Pharma LLC
• Nyeshia Sherelle Cohill
• Stacey Colebrook, RN
• College Park Dialysis, LLC
• College Park Regional Health Center
• Yasmin Collier-Kenney, RN

• Internal Medicine Physician in College Park, GA
• Providers in College Park, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.