MEDICARE: DEGEER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center	AS180264963	MI

General Provider Information

NPI Number	:	1831466465
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEGEER INC

Provider Business Mailing Address
First Line	:	7050 BEAVERTON RD
Second Line	:
City	:	LAKE
State	:	MI
Zip	:	48632-9209
Country	:	US
Telephone Number	:	989-544-3605
Fax Number	:

Provider Business Practice Location Address
First Line	:	7886 MCKINLEY AVE
Second Line	:
City	:	LAKE
State	:	MI
Zip	:	48632-9207
Country	:	US
Telephone Number	:	989-544-2756
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JOEL DEGEER JR.
Credential	:
Telephone Number	:	989-544-3605

Provider Enumeration Date	:	11/28/2011
Last Update Date	:	11/28/2011

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