Organization
EASTSIDE OUTPATIENT SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DARIEN LAMARCK SMITH (EXECUTIVE DIRECTOR)
(231) 739-4359
Entity
Organization
Contact information
Practice address
445 E SHERMAN BLVD, MUSKEGON, MI 49444-2203
(231) 739-4359
(231) 733-6151
Mailing address
445 E SHERMAN BLVD, MUSKEGON, MI 49444-2203
(231) 739-4359
(231) 733-6151
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
610030
MI
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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