Provider Demographics
NPI:1366735607
Name:FRONT PORCH HEALTH, INC
Entity type:Organization
Organization Name:FRONT PORCH HEALTH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VICKERS
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:407-797-3175
Mailing Address - Street 1:900 FONTANA LN
Mailing Address - Street 2:
Mailing Address - City:KENANSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34739-9010
Mailing Address - Country:US
Mailing Address - Phone:407-797-3175
Mailing Address - Fax:
Practice Address - Street 1:4755 N KENANSVILLE RD
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:FL
Practice Address - Zip Code:34773-9109
Practice Address - Country:US
Practice Address - Phone:407-797-3175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL851162163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty