Organization
FRONT ST. INC.
Active
Parent organization
FRONT ST. INC.
Other names
Housing Support Team
Organization subpart
Yes
Provider details
NPI number
Legal business name
FRONT ST. INC.
Authorized official
JONATHAN P BUTLER (VICE PRESIDENT)
(831) 515-2393
Entity
Organization
Contact information
Practice address
1201 SHAFFER RD, BLDG 1, SUITE 1A, SANTA CRUZ, CA 95060-5761
(831) 420-0120
Mailing address
303 POTRERO ST STE 42-102, SANTA CRUZ, CA 95060-2779
(831) 420-0120
(831) 420-0136
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
—
44AV
MEDI-CAL PRV NBR
CA
Enumeration date
04/23/2009
Last updated
04/23/2024
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