Provider Demographics
NPI:1518639723
Name:FRONT PORCH COMMUNITIES AND SERVICES
Entity Type:Organization
Organization Name:FRONT PORCH COMMUNITIES AND SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIR. RISK MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:
Authorized Official - Last Name:EDELSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-956-7360
Mailing Address - Street 1:2185 N CALIFORNIA BLVD STE 215
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-3566
Mailing Address - Country:US
Mailing Address - Phone:925-956-7360
Mailing Address - Fax:925-956-7360
Practice Address - Street 1:1055 N KINGSLEY DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1207
Practice Address - Country:US
Practice Address - Phone:323-661-1128
Practice Address - Fax:323-660-4091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA197608482OtherCA DEPARTMENT OF SOCIAL SERVICES