Organization
ASTRUM WELLNESS AND RECOVERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LATIBEAUDIER (CO DIRECTOR)
(260) 280-3341
Entity
Organization
Contact information
Practice address
129 E DEWALD ST, FORT WAYNE, IN 46803-3317
(260) 280-3341
Mailing address
2712 N WELLS ST, FORT WAYNE, IN 46808-2102
(317) 608-7856
Taxonomy
Speciality
Code
Description
License number
State
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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