Organization
EASTSIDE OUTPATIENT SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARIEN L. SMITH (PROGRAM DIRECTOR)
(231) 206-9612
Entity
Organization
Contact information
Practice address
445 E SHERMAN BLVD, MUSKEGON, MI 49444-2203
(231) 739-4359
Mailing address
445 E SHERMAN BLVD, MUSKEGON, MI 49444-2203
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/01/2020
Last updated
05/01/2020
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