Provider Demographics
NPI:1669913794
Name:PEACEFUL HEARTS ADULT DAY TREATMENT LLC
Entity type:Organization
Organization Name:PEACEFUL HEARTS ADULT DAY TREATMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESTINY
Authorized Official - Middle Name:UNIQUE
Authorized Official - Last Name:ARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-550-6615
Mailing Address - Street 1:19360 LIVERNOIS AVE
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48221-1761
Mailing Address - Country:US
Mailing Address - Phone:248-550-6615
Mailing Address - Fax:
Practice Address - Street 1:19360 LIVERNOIS AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-1761
Practice Address - Country:US
Practice Address - Phone:248-550-6615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty