Peace in Young Life Center, Inc.

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

PEACE IN YOUNG LIFE CENTER, INC.

Doing business as

Peace House

Practice address

15471 Cloverlawn St
Detroit, MI 48238-1146

Phone

(313) 220-9033

Fax

(313) 345-4358

NPI assigned

Dec 5, 2007

Last updated

Feb 25, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marchelle Mitzi Gaines, MSW

Title

Ceo

Phone

(313) 220-9033

Specialties & licenses 1

Addresses

Other names 1

• Peace House Doing business as

Tax ID family

Peace House2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Peace in Young Life Center, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Calhoun, GA
  • NPI 1447447362
  NPD tax ID

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361750400000",
    "number": "1386826949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15471 CLOVERLAWN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482381146",
            "telephone_number": "706-263-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15471 CLOVERLAWN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482381146",
            "telephone_number": "313-220-9033",
            "fax_number": "313-345-4358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE IN YOUNG LIFE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2013-02-25",
        "status": "A",
        "authorized_official_last_name": "GAINES",
        "authorized_official_first_name": "MARCHELLE",
        "authorized_official_middle_name": "MITZI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "313-220-9033",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peace House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• PCT Home Help Agency LLC
• PCT Home Help Angency
• PDC Managemen
• James O. Peabody, M.D.
• Peace Be Still PLLC
• Peace of Mind Transportation LLC
• Peace of Mine Health & Human Services
• Peaceful Hearts Adult Day Care 2
• Peaceful Hearts Adult Day Treatment LLC
• Peaceful Surroundings

• Addiction (Substance Use Disorder) Counselor in Detroit, MI
• Providers in Detroit, MI by specialty
• Addiction (Substance Use Disorder) Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2013; 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.