# FRONT PORCH COMMUNITIES AND SERVICES

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Fredericka Manor, Fredericka Manor Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366871287
- **Authorized official:** GRANT EDELSTONE (SR. DIRECTOR RISK MANAGEMENT)
- **Authorized official phone:** (925) 956-7360

## Contact information

- **Practice address:** 111 THIRD AVE, CHULA VISTA, CA 91910-1822
- **Practice address phone:** (619) 427-2777
- **Practice address fax:** (619) 427-0394
- **Mailing address:** 2185 N CALIFORNIA BLVD STE 215, WALNUT CREEK, CA 94596-3566
- **Mailing address phone:** (415) 823-5354
- **Mailing address fax:** (925) 956-7360

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 374600802 | CA | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 11/01/2013
- **Last updated:** 07/29/2021