Coastal Senior Living Facility LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

COASTAL SENIOR LIVING FACILITY LLC

Practice address

6024 Golf and Sea Blvd
Apollo Beach, FL 33572-2628

Phone

(813) 213-1291

NPI assigned

Feb 16, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Chevelle Jordan, RNNPI 1932729241

Title

Owner

Phone

(727) 417-1723

Specialties & licenses 8

Addresses

Other names 1

• Coastal Senior Living Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chevelle R Jordan, REGISTERED NURSE

  • General Practice Registered Nurse
  • Ruskin, FL
  • NPI 1932729241

  Respite Care

  NPD Authorized official

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

{
    "created_epoch": "1708041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708041600000",
    "number": "1912762147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 APOLLO BEACH BLVD # 182",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722251",
            "telephone_number": "727-417-1723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6024 GOLF AND SEA BLVD",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335722628",
            "telephone_number": "813-213-1291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL SENIOR LIVING FACILITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-16",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CHEVELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-417-1723",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Apollo Beach, FL
• Providers in Apollo Beach, 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 16, 2024; 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.