Organization
KINGSTON RESIDENCE OF FORT WAYNE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA SIU (DIRECTOR OF OPERATIONS)
(419) 392-8529
Entity
Organization
Contact information
Practice address
7515 WINCHESTER RD, FORT WAYNE, IN 46819-2257
(260) 747-1523
Mailing address
1 SEAGATE STE 1960, TOLEDO, OH 43604-1592
(419) 725-1938
(419) 247-2872
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/08/2024
Last updated
08/08/2024
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