Provider Demographics
NPI:1225594187
Name:R CHRISTOPHER DEBOER PLLC
Entity Type:Organization
Organization Name:R CHRISTOPHER DEBOER PLLC
Other - Org Name:RED CEDAR RELATIONSHIP COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:DEBOER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:517-918-4371
Mailing Address - Street 1:433 DORRANCE PL
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1501
Mailing Address - Country:US
Mailing Address - Phone:517-918-4371
Mailing Address - Fax:
Practice Address - Street 1:2395 JOLLY RD STE 160
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-5977
Practice Address - Country:US
Practice Address - Phone:517-918-4371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health