Provider Demographics
NPI:1235621251
Name:ALCOHOL AND CHEMICAL ABUSE CONSULTANTS INC
Entity Type:Organization
Organization Name:ALCOHOL AND CHEMICAL ABUSE CONSULTANTS INC
Other - Org Name:ACAC, INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAE ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:OAKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-957-5850
Mailing Address - Street 1:3940 PENINSULAR DR SE STE 240
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2443
Mailing Address - Country:US
Mailing Address - Phone:616-957-5850
Mailing Address - Fax:616-957-5853
Practice Address - Street 1:3940 PENINSULAR DR SE STE 240
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-2443
Practice Address - Country:US
Practice Address - Phone:616-957-5850
Practice Address - Fax:616-957-5853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-05
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISA0410049101YA0400X
101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICV0030055Medicaid