Organization
P.E.A.C.E. IN YOUNG LIFE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARCHELLE MITZI GAINES (CEO)
(313) 220-9033
Entity
Organization
Contact information
Practice address
15471 CLOVERLAWN ST, STE 101, DETROIT, MI 48238-1146
(313) 345-3853
(313) 345-4358
Mailing address
15471 CLOVERLAWN ST, DETROIT, MI 48238-1146
(313) 345-3853
(313) 345-4358
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
12/29/2006
Last updated
08/01/2007
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