Provider Demographics
NPI:1548609654
Name:ON MY OWN OF MICHIGAN, INC
Entity Type:Organization
Organization Name:ON MY OWN OF MICHIGAN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ROCCANTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-649-3739
Mailing Address - Street 1:1250 KIRTS BLVD
Mailing Address - Street 2:STE. 300
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4855
Mailing Address - Country:US
Mailing Address - Phone:248-649-3739
Mailing Address - Fax:248-649-3749
Practice Address - Street 1:1250 KIRTS BLVD
Practice Address - Street 2:STE. 300
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4855
Practice Address - Country:US
Practice Address - Phone:248-649-3739
Practice Address - Fax:248-649-3749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-21
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services