Front Street

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

FCL-051-017 Issued in NC

Legal business name

FRONT STREET

Practice address

204 E Ridge Cir
Clayton, NC 27520-2023

Phone

(919) 553-1958

Fax

(919) 553-1958

NPI assigned

Mar 29, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Luella Tate

Title

Owner

Phone

(919) 553-1958

Specialties & licenses 1

Addresses

Tax ID family

Brost Court2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Brost Court

  • Mental Illness Community Based Residential Treatment Facility
  • Raleigh, NC
  • NPI 1881714343
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354838400000",
    "number": "1205956760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25752",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276115752",
            "telephone_number": "919-553-1958",
            "fax_number": "919-553-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 E RIDGE CIR",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275202023",
            "telephone_number": "919-553-1958",
            "fax_number": "919-553-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONT STREET",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-12-07",
        "status": "A",
        "authorized_official_last_name": "TATE",
        "authorized_official_first_name": "LUELLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-553-1958",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NC",
            "license": "FCL-051-017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Franklin, PA-C
• Monica Machelle Frazier, CNA
• Hannah Marie Freyman, DDS
• William L Friedrich, LPC
• Friendly Forever Homecare, LLC
• Emily Victoria Fry, LPC-A, LCAS-A, NCC
• Liliana Galvan, QP, MSW, LCSWA
• Christina Gambino
• Gateway Pediatric Therapy
• Donald Thomas Gentrup, PHARMD

• Assisted Living Facility in Clayton, NC
• Providers in Clayton, NC by specialty
• Assisted Living Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.