Healthcare Provider Details

I. General information

NPI: 1427984970
Provider Name (Legal Business Name): FRONT ST RESIDENTIAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 SANTA CRUZ ST # CA95060
SANTA CRUZ CA
95060-6117
US

IV. Provider business mailing address

4221 WILSHIRE BLVD STE 392
LOS ANGELES CA
90010-3537
US

V. Phone/Fax

Practice location:
  • Phone: 831-427-3387
  • Fax:
Mailing address:
  • Phone: 323-475-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: STEVEN ATLAS
Title or Position: MANAGER
Credential:
Phone: 323-475-1800