NPIMap

Organization Active NPI

Front Porch Communities and Services

Doing business as Kingsley Manor Care Center

  • Skilled Nursing Facility
  • Los Angeles, CA
National Provider Identifier
1396821971
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
970000015 Issued in CA
Legal business name
FRONT PORCH COMMUNITIES AND SERVICES
Doing business as
Kingsley Manor Care Center
Practice address
1055 N Kingsley Dr
Los Angeles, CA 90029-1207
Phone
(323) 661-1128
Fax
(323) 661-4121
NPI assigned
Oct 27, 2006
Last updated
Jul 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Authorized official

Name
Grant Edelstone
Title
Sr. Director Risk Management
Phone
(925) 956-7360

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 197602346 CA
Skilled Nursing Facility 314000000X 970000015 CA Primary

Addresses

Primary practice location

1055 N Kingsley Dr
Los Angeles, CA 90029-1207

Mailing address

1055 N Kingsley Dr
Los Angeles, CA 90029-1207
Phone (323) 661-1128

Other identifiers 2

IdentifierTypeStateIssuer
RCF00015FMedicaidCA
ZZT05086GMedicaidCA

Other names 1

  • Kingsley Manor Care Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Claremont Manor Care Center4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627516800000",
    "number": "1396821971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N KINGSLEY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291207",
            "telephone_number": "323-661-1128",
            "fax_number": "323-661-4121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N KINGSLEY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291207",
            "telephone_number": "323-661-1128",
            "fax_number": "323-661-4121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONT PORCH COMMUNITIES AND SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A",
        "authorized_official_last_name": "EDELSTONE",
        "authorized_official_first_name": "GRANT",
        "authorized_official_title_or_position": "SR. DIRECTOR RISK MANAGEMENT",
        "authorized_official_telephone_number": "925-956-7360"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "CA",
            "license": "197602346",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "970000015",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "RCF00015F",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05086G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kingsley Manor Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kingsley Manor Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; 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.