Organization
BOYS & GIRLS REPUBLIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARYJANE PECK LMSW (EXECUTIVE DIRECTOR)
(248) 476-9550
Entity
Organization
Contact information
Practice address
28000 W 9 MILE RD, FARMINGTON HILLS, MI 48336-3812
(248) 476-9550
(248) 473-6332
Mailing address
28000 W 9 MILE RD, FARMINGTON HILLS, MI 48336-3812
(248) 476-9550
(248) 473-6332
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
—
MI
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
C1630200987
MI
Other
Enumeration date
01/12/2007
Last updated
09/11/2025
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