Organization
HOPE SHORES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN WICKSON (OWNER)
(810) 964-0412
Entity
Organization
Contact information
Practice address
1383 E MAPLE AVE, BURTON, MI 48529-2059
(810) 964-0412
Mailing address
10242 MCKINLEY RD, MONTROSE, MI 48457-9187
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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