MEDICARE: ALTERNATIVE COMMUNITY LIVING, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	AS6300784497	MI
2	320800000X	Mental Illness Community Based Residential Treatment Facility
3	320700000X	Physical Disabilities Residential Treatment Facility
4	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1942416078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALTERNATIVE COMMUNITY LIVING, INC.

Provider Business Mailing Address
First Line	:	3075 ORCHARD VISTA DR SE
Second Line	:
City	:	GRAND RAPIDS
State	:	MI
Zip	:	49546-7069
Country	:	US
Telephone Number	:	616-301-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	269 HIGHLAND AVE
Second Line	:
City	:	BLOOMFIELD HILLS
State	:	MI
Zip	:	48302-0632
Country	:	US
Telephone Number	:	248-335-4904
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	TIMOTHY BECKER
Credential	:
Telephone Number	:	616-301-8000

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	06/03/2026

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