Organization
ONE LIFE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW CURT OWEN (EXECUTIVE DIRECTOR)
(517) 303-4132
Entity
Organization
Contact information
Practice address
2222 W GRAND RIVER AVE STE A, OKEMOS, MI 48864-1604
(517) 303-4132
Mailing address
4686 S PENINSULA RD, HALE, MI 48739-8917
(517) 303-4132
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
08/14/2024
Last updated
08/14/2024
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