P.E.A.C.E. IN YOUNG LIFE CENTER, INC. (NPI# 1891851226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891851226 |
| Entity Type | Organization |
| Organization Name | P.E.A.C.E. IN YOUNG LIFE CENTER, INC. |
| Practice Address |
15471 Cloverlawn St Ste 101 Detroit MI 48238-1146 |
| Mailing Address |
15471 Cloverlawn St Detroit MI 48238-1146 |
| Practice Telephone | 3133453853 |
| Practice Fax Number | 3133454358 |
| Mailing Telephone | 3133453853 |
| Mailing Fax Number | 3133454358 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2007-08-01 |
| Authorized Official Name | MS. MARCHELLE MITZI GAINES (CEO) |
| Authorized Official Telephone | 3132209033 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
Residential Treatment Facilities |
| Street Address |
15471 CLOVERLAWN ST STE 101 |
| City | DETROIT |
| State | MI |
| Zip Code | 48238-1146 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386826949 | Peace In Young Life Center, Inc. | Counselor | 15471 Cloverlawn St, Detroit, MI 48238-1146 | 2007-12-05 |
| 1295867174 | Servilla V Harris | Social Worker | 15471 Cloverlawn St, Ste 101, Detroit, MI 48238-1146 | 2007-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700372224 | Cardinal Home Healthcare Group, LLC | Home Health | 3165 Oakman Boulvard, Detroit, MI 48238 | 2018-07-09 |
| 1063963684 | Lydia Adkins | Counselor | 13505 Lasalle St, Apt 305, Detroit, MI 48238 | 2016-10-19 |
| 1750837324 | A Plus Care Transportation LLC | Clinic/Center | 14586 Wisconsin, Detroit, MI 48238 | 2016-09-01 |
| 1518413756 | Valarie Grayer - Felton | Case Manager/Care Coordinator | 15941 Fairfield St., Detroit, MI 48238 | 2016-08-28 |
| 1144773722 | Juanna Cherise Hardaway | Case Manager/Care Coordinator | 1935 Pasadena, Detroit, MI 48238 | 2016-07-29 |
| 1336503556 | Gladys S Chambers | Home Health Aide | 15473 Wisconsin, Detroit, MI 48238 | 2016-04-13 |
| 1891158788 | Karla Gill | Licensed Practical Nurse | 153060 Wildemere, Detroit, MI 48238 | 2016-03-30 |
| 1790145548 | Cecil Cosey IIi | Psychologist | 11000 W Micnichols, Detroit, MI 48238 | 2016-03-07 |
| 1508264102 | Sav-med Pharmacy Inc | Pharmacy | 2645 West Davison, Detroit, MI 48238 | 2014-12-12 |
| 1760887020 | Monument Dental PC | Dentist | 15510 Livernois Avenue, Detroit, MI 48238 | 2014-10-29 |
| Find all providers in zip 48238 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851682215 | Detroit Rescue Mission Ministries | Substance Abuse Rehabilitation Facility | 19211 Anglin, Detroit, MI 48234 | 2011-04-20 |
| 1881921401 | Todd-phillips Children's Home | Substance Abuse Rehabilitation Facility | 8141 E Outer Dr, Detroit, MI 48213-1323 | 2009-11-04 |
| 1851544688 | Lois Ann Brown-nelson | Substance Abuse Rehabilitation Facility | 14460 Mayfield St, Detroit, MI 48205-4131 | 2008-10-24 |
| 1437536802 | Detroit Rescue Mission Ministries | Substance Abuse Rehabilitation Facility | 19211 Anglin St, Detroit, MI 48234-1460 | 2015-05-05 |
| 1215203963 | Steps II Sap LLC | Substance Abuse Rehabilitation Facility | 8141 E Outer Dr, Detroit, MI 48213-1323 | 2012-03-27 |
| 1356543888 | Laverne Denise Mcglothian | Substance Abuse Rehabilitation Facility | 5555 Conner St, 2000 North, Detroit, MI 48213-3448 | 2007-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972156701 | Flint Odyssey House Inc. | Substance Abuse Rehabilitation Facility | 932 Beach St, Flint, MI 48502-1502 | 2019-07-21 |
| 1669899241 | Great Lakes Recovery Centers, Inc. | Substance Abuse Rehabilitation Facility | 104 Malton Road, Negaunee, MI 49866 | 2014-03-21 |
| 1891978441 | Wolverine Human Services | Substance Abuse Rehabilitation Facility | 150 Enterprise Dr, Vassar, MI 48768-9584 | 2007-12-06 |
| 1588706915 | Starr Commonwealth | Substance Abuse Rehabilitation Facility | 13725 Starr Commonwealth, Albion, MI 49224-9580 | 2007-02-13 |
| 1831682947 | Michele Baldori | Substance Abuse Rehabilitation Facility | 50430 School House Rd, Canton, MI 48187-5910 | 2018-06-13 |
| 1982128393 | Flint Odyssey House, Inc. | Substance Abuse Rehabilitation Facility | 718 Oak St, Flint, MI 48503-2614 | 2017-07-27 |
| 1285932459 | Detroit Rescue Mission Ministries | Substance Abuse Rehabilitation Facility | 91 Glendale St, Highland Park, MI 48203-3274 | 2011-03-11 |
| 1891017372 | Dial Help, Inc. | Substance Abuse Rehabilitation Facility | 609 Shelden Ave, Houghton, MI 49931-1835 | 2010-02-24 |
| 1548596216 | Wolverine Human Services | Substance Abuse Rehabilitation Facility | 1120 Commerce Dr, Vassar, MI 48768-9588 | 2009-10-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.