Organization
HEARTH AT SYCAMORE VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE DEFFENBAUGH (EXECUTIVE DIRECTOR)
(260) 625-4025
Entity
Organization
Contact information
Practice address
611 W COUNTY LINE RD S, FORT WAYNE, IN 46814-7592
(260) 625-4025
Mailing address
611 W COUNTY LINE RD S, FORT WAYNE, IN 46814-7592
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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