Organization
AVENUES RECOVERY CENTER OF FORT WAYNE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE SCHLEICHER (DIRECTOR OF REGULATORY COMPLIANCE)
(732) 967-2635
Entity
Organization
Contact information
Practice address
2626 FAIRFIELD AVE, FORT WAYNE, IN 46807-1215
(732) 307-8000
Mailing address
1600 AVENUE OF THE STATES STE 700, LAKEWOOD, NJ 08701-4909
(732) 967-2635
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
05/07/2026
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