Provider Demographics
NPI:1588704670
Name:EARLY SOLUTIONS CLINIC, LLC
Entity type:Organization
Organization Name:EARLY SOLUTIONS CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:ALFONSO
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:810-240-8800
Mailing Address - Street 1:PO BOX 988
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-0988
Mailing Address - Country:US
Mailing Address - Phone:810-600-1400
Mailing Address - Fax:810-600-1403
Practice Address - Street 1:13000 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-2200
Practice Address - Country:US
Practice Address - Phone:734-261-2800
Practice Address - Fax:734-261-2810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704224985261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOP27580Medicare ID - Type UnspecifiedMEDICARE PART B