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KINGSLEY MANOR
NPI 1194130005
Assisted Living Facility in Los Angeles, CA

Active since June 30, 2014CLIA 05D0543256 · Waiver
1055 N KINGSLEY DR, LOS ANGELES, CA 90029(323) 661-1128(323) 661-4121 Get Directions Write a Review

NPPES record last updated: June 30, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kingsley Manor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KINGSLEY MANOR (NPI 1194130005) is a healthcare organization registered as an assisted living facility in Los Angeles, California and active in the NPI registry since June 2014. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Roberta Jacobsen, President, as its authorized official.

NPPES Registry Identity

NPI1194130005
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameFRONT PORCH COMMUNITIES OPERATING GROUP, LLC
Location Address1055 N KINGSLEY DRLos Angeles, CA 90029-1207
Mailing Address800 N Brand Blvd, 19th FloorGlendale, CA 91203-1245 · (818) 254-4100 · Fax (818) 254-4101
Phone(323) 661-1128
Fax(323) 661-4121
Organization SubpartYesParent: Front Porch Communities And Services
Authorized OfficialRoberta JacobsenPresident · (818) 729-8100
Enumeration DateJune 30, 2014
✔ NPI 1194130005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in CA · 197608482
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
1055 N KINGSLEY DR, Los Angeles, CA 90029
Open in Google Maps ↗

Other Names 1

Doing Business AsKingsley Manor

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0543256

Kingsley Manor Care Center · Los Angeles, CA
Active · expires Aug 31, 2026
CLIA Number05D0543256
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDr. Azmy F. Ghaly
Laboratory Phone(323) 906-3300
Laboratory LocationKingsley Manor Care Center1055 N Kingsley Dr, Los Angeles, CA 90029
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FRONT PORCH COMMUNITIES AND SERVICES
Skilled Nursing Facility
1055 N KINGSLEY DR
LOS ANGELES, CA 90029
Los Angeles County (323) 661-1128
FRONT PORCH COMMUNITIES AND SERVICES
Assisted Living Facility
1055 N KINGSLEY DR
LOS ANGELES, CA 90029
Los Angeles County (323) 661-1128
FRONT PORCH COMMUNITIES OPERATING GROUP LLC
Skilled Nursing Facility
1055 N KINGSLEY DR
LOS ANGELES, CA 90029
Los Angeles County (323) 661-1128
HRANT AGAKHANYAN OTD, OTR
Occupational Therapist
1055 N KINGSLEY DR
LOS ANGELES, CA 90029
Los Angeles County (323) 661-1128

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Front Porch Communities Operating Group, LLC's NPI number?

The NPI number for Front Porch Communities Operating Group, LLC is 1194130005. It was assigned to this organization in the NPPES registry on June 30, 2014. The provider is doing business as Kingsley Manor.

Where is Front Porch Communities Operating Group, LLC located?

Front Porch Communities Operating Group, LLC is located at 1055 N Kingsley Dr, Los Angeles, CA 90029. The listed phone number is (323) 661-1128.

What is Front Porch Communities Operating Group, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Front Porch Communities Operating Group, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D0543256) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Front Porch Communities Operating Group, LLC was last updated on June 30, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.