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
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1003475849
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	:	36211 JEFFERSON AVE
Second Line	:
City	:	HARRISON TOWNSHIP
State	:	MI
Zip	:	48045-2906
Country	:	US
Telephone Number	:	586-465-4780
Fax Number	:

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

Provider Enumeration Date	:	06/06/2019
Last Update Date	:	06/03/2026

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