Provider Demographics
NPI:1831466465
Name:DEGEER INC
Entity Type:Organization
Organization Name:DEGEER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEGEER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:989-544-3605
Mailing Address - Street 1:7050 BEAVERTON RD
Mailing Address - Street 2:
Mailing Address - City:LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48632-9209
Mailing Address - Country:US
Mailing Address - Phone:989-544-3605
Mailing Address - Fax:
Practice Address - Street 1:7886 MCKINLEY AVE
Practice Address - Street 2:
Practice Address - City:LAKE
Practice Address - State:MI
Practice Address - Zip Code:48632-9207
Practice Address - Country:US
Practice Address - Phone:989-544-2756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAS180264963261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health