Life Services System of Ottawa County

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

6801096280 Issued in MI

Legal business name

LIFE SERVICES SYSTEM OF OTTAWA COUNTY

Doing business as

Life Services Parent Center

Practice address

11172 Adams St
Holland, MI 49423-9163

Phone

(616) 396-7566

Fax

(616) 396-6893

NPI assigned

Mar 4, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Deanna Depree

Title

Director

Phone

(616) 396-7566

Specialties & licenses 1

Addresses

Other names 1

• Life Services Parent Center Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1508281288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11172 ADAMS ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494239163",
            "telephone_number": "616-396-7566",
            "fax_number": "616-396-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11172 ADAMS ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494239163",
            "telephone_number": "616-396-7566",
            "fax_number": "616-396-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SERVICES SYSTEM OF OTTAWA COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "DEPREE",
        "authorized_official_first_name": "DEANNA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "616-396-7566",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "MI",
            "license": "6801096280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Services Parent Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Early Intervention Provider Agency in Holland, MI
• Providers in Holland, MI by specialty
• Early Intervention Provider Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.