Provider Demographics
NPI:1881840197
Name:FRONT PORCH COMMUNITIES AND SERVICES
Entity Type:Organization
Organization Name:FRONT PORCH COMMUNITIES AND SERVICES
Other - Org Name:CLAREMONT MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR. DIRECTOR 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:415-823-5354
Mailing Address - Fax:925-956-7360
Practice Address - Street 1:650 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-4538
Practice Address - Country:US
Practice Address - Phone:909-626-1227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197802724310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility