Fort Wayne Al, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

FORT WAYNE AL, LLC

Practice address

2116 Butler Rd
Fort Wayne, IN 46808-4420

Phone

(260) 471-0944

NPI assigned

Dec 31, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jonathan Litt

Title

Secretary/Treasurer

Phone

(646) 844-3603

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1735603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1669281085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 BUTLER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468084420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 BUTLER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468084420",
            "telephone_number": "260-471-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT WAYNE AL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-31",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "LITT",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "646-844-3603"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Lee Fornal, DPT
• Dana R Forrest, MD
• Jeri Ann Forrest, LCSW
• Deanna Forsythe
• Fort Wayne Aal LP (Silver Birch of Fort Wayne)
• Fort Wayne Allergy and Asthma Consultants, Inc.
• Fort Wayne Allergy and Asthma Consultants, Inc.
• Fort Wayne Audiology Consultants, LLC (Lowe Audiology and Hearing Care)
• Fort Wayne Autism Center Inc
• Fort Wayne Brain & Spine Center LLC

• Assisted Living Facility in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Assisted Living Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.