Organization
FORT WAYNE AL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LITT (SECRETARY/TREASURER)
(646) 844-3603
Entity
Organization
Contact information
Practice address
2116 BUTLER RD, FORT WAYNE, IN 46808-4420
(260) 471-0944
Mailing address
2116 BUTLER RD, FORT WAYNE, IN 46808-4420
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/31/2024
Last updated
12/31/2024
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