Provider Demographics
NPI:1194130005
Name:FRONT PORCH COMMUNITIES OPERATING GROUP, LLC
Entity type:Organization
Organization Name:FRONT PORCH COMMUNITIES OPERATING GROUP, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACOBSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-729-8100
Mailing Address - Street 1:800 N BRAND BLVD
Mailing Address - Street 2:19TH FLOOR
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1245
Mailing Address - Country:US
Mailing Address - Phone:818-254-4100
Mailing Address - Fax:818-254-4101
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:323-661-4121
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRONT PORCH COMMUNITIES AND SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-30
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA197608482310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility