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General NPI Number Information
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NPI Number | 1710210505
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Entity Type | Organization
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Legal Business Name | FRONT ST INC
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Dates
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Enumeration Date | 09/10/2009
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 399 DRAKE AVE
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City | MONTEREY
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State | CA
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Zip | 93940-7504
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Country | US
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Telephone | 831-643-9069
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Fax |
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Provider Business Mailing Address
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Address Line | 2115 7TH AVE
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City | SANTA CRUZ
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State | CA
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Zip | 95062-1663
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Country | US
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Telephone | 831-420-0120
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Fax | 831-420-0123
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Authorized Official
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Title or Position | CEO AND OWNER
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Name | ANN M. BUTLER
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Credential |
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Telephone | 831-420-0120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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