Organization
P.E.A.C.E. IN YOUNG LIFE CENTER, INC.
Active
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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