Organization
CAPITAL SENIOR LIVING PROPERTIES 4, INC.
Active
Other names
CSL Fort Wayne, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DAN KENYON (VP AND SECRETARY)
(972) 770-5600
Entity
Organization
Contact information
Practice address
3320 EAST STATE BOULEVARD, FORT WAYNE, IN 46805
(260) 483-4343
(812) 406-1101
Mailing address
3320 EAST STATE BOULEVARD, FORT WAYNE, IN 46805
(260) 483-4343
(812) 406-1101
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
13-012107-1
IN
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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