Healthcare Provider Details

I. General information

NPI: 1083545073
Provider Name (Legal Business Name): GRACE BRINDLE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 W KAYE AVE
MARQUETTE MI
49855-2729
US

IV. Provider business mailing address

433 SILVER CREEK RD
MARQUETTE MI
49855-9341
US

V. Phone/Fax

Practice location:
  • Phone: 989-249-3391
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: GRACE BRINDLE
Title or Position: OWNER
Credential: LLC
Phone: 765-376-4344