Provider Demographics
NPI:1235705443
Name:GRACE ABOUND LLC
Entity Type:Organization
Organization Name:GRACE ABOUND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOLORES
Authorized Official - Middle Name:A
Authorized Official - Last Name:ALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:989-286-3777
Mailing Address - Street 1:PO BOX 289
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-0289
Mailing Address - Country:US
Mailing Address - Phone:989-286-3777
Mailing Address - Fax:989-672-4974
Practice Address - Street 1:4050 POLE BUILDING DR
Practice Address - Street 2:
Practice Address - City:KINGSLEY
Practice Address - State:MI
Practice Address - Zip Code:49649-8212
Practice Address - Country:US
Practice Address - Phone:231-735-3705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility