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Eastern Clinic Pllc
Methadone Clinic in Grand Rapids, Michigan
NPI 1942675426

Eastern Clinic Pllc is a Methadone Clinic based in Grand Rapids, MI and is specialized in Methadone. Eastern Clinic Pllc practices in Grand Rapids, MI. The NPI Number for Eastern Clinic Pllc is 1942675426 and holds a License No. SA0410165 (Michigan).

The current practice location address for Eastern Clinic Pllc is 1555 Eastern Ave Se, Grand Rapids, MI and can be reached out via phone at 616-243-6262 and via fax at 616-243-6969.

Location: 1555 Eastern Ave Se, Grand Rapids, MI, 49507-2055
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1942675426
Provider Name
Eastern Clinic Pllc
Credential
Provider Entity Type
Organization
Address
1555 Eastern Ave Se, Grand Rapids, MI, 49507-2055
Phone Number
616-243-6262
Fax Number
616-243-6969
Provider Enumeration Date
12/09/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1555 Eastern Ave Se
City
Grand Rapids
State
Michigan
Zip
49507-2055
Phone Number
616-243-6262
Fax Number
616-243-6969
person
Provider Business Mailing Address Details
Address
1555 Eastern Ave Se
City
Grand Rapids
State
Michigan
Zip
49507-2055
Phone Number
616-243-6262
Fax Number
616-243-6969
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Methadone
Taxonomy
261QM2800X
License No.
SA0410165 (Michigan)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
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