Organization
FRONT ST. INC.
Active
Parent organization
FRONT ST. INC.
Other names
Wheelock Residential
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRONT ST. INC.
Authorized official
ANN M. BUTLER (CEO AND OWNER)
(831) 420-0120
Entity
Organization
Contact information
Practice address
102 WHEELOCK RD, WATSONVILLE, CA 95076-9719
(831) 420-0120
(831) 420-0123
Mailing address
2115 7TH AVE, SANTA CRUZ, CA 95062-1663
(831) 420-0120
(831) 420-0123
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44CZ
MEDI-CAL PRV NBR
CA
Enumeration date
06/12/2009
Last updated
08/17/2022
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