| NPI | 1104635887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELIZABETH WICKS Owner/CEO 269-519-4626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-08-27 |