Provider Demographics
NPI:1447445358
Name:EARLY SOLUTIONS CLINIC
Entity type:Organization
Organization Name:EARLY SOLUTIONS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIET
Authorized Official - Middle Name:A
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:810-600-1400
Mailing Address - Street 1:2333 S. CENTER ROAD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:MI
Mailing Address - Zip Code:48519
Mailing Address - Country:US
Mailing Address - Phone:810-600-1400
Mailing Address - Fax:810-600-1403
Practice Address - Street 1:8650 W GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-2327
Practice Address - Country:US
Practice Address - Phone:810-534-1220
Practice Address - Fax:810-534-1203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2007-09-13
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
MIOP27590Medicare PIN