Provider Demographics
NPI:1528288784
Name:G.R.A.C.E. CENTER
Entity type:Organization
Organization Name:G.R.A.C.E. CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:AKALIS
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LLP,CSW
Authorized Official - Phone:989-348-2544
Mailing Address - Street 1:PO BOX 561
Mailing Address - Street 2:
Mailing Address - City:GRAYLING
Mailing Address - State:MI
Mailing Address - Zip Code:49738-0561
Mailing Address - Country:US
Mailing Address - Phone:989-348-2544
Mailing Address - Fax:989-348-7617
Practice Address - Street 1:6459 WEST M-72
Practice Address - Street 2:
Practice Address - City:GRAYLING
Practice Address - State:MI
Practice Address - Zip Code:49738
Practice Address - Country:US
Practice Address - Phone:989-348-2544
Practice Address - Fax:989-348-7617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI200005101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty