Organization
FRONT ST INC
Active
Parent organization
FRONT ST INC
Other names
Opal Cliff Residential Center
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
4795 OPAL CLIFF DR, CAPITOLA, CA 95062-5229
(831) 420-0120
(831) 420-0136
Mailing address
2115 7TH AVE, SANTA CRUZ, CA 95062-1663
(831) 420-0120
(831) 420-0136
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4476
MEDI-CAL PRV NBR
CA
Enumeration date
04/18/2007
Last updated
08/17/2022
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