Boys & Girls Republic

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

C1630200987 Issued in MI

Legal business name

BOYS & GIRLS REPUBLIC

Practice address

28000 W 9 Mile Rd
Farmington Hills, MI 48336-3812

Phone

(248) 476-9550

Fax

(248) 473-6332

NPI assigned

Jan 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Maryjane Peck, LMSW

Title

Executive Director

Phone

(248) 476-9550

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1154472710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28000 W 9 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483363812",
            "telephone_number": "248-476-9550",
            "fax_number": "248-473-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28000 W 9 MILE RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483363812",
            "telephone_number": "248-476-9550",
            "fax_number": "248-473-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOYS & GIRLS REPUBLIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "MARYJANE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "248-476-9550",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "MI",
            "license": "C1630200987",
            "primary": true
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Boylston
• Dawn Boyne
• Cheyenne Boynton
• Jon Boynton
• Princess Boynton
• Hannah N Boyt
• Melissa Ann Bozelak, OT
• Kayana Bozeman
• Miranda Bozmoski
• Amelia Braams

• Emotionally Disturbed Childrens' Residential Treatment Facility in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.