MEDICARE: EARLY SOLUTIONS CLINIC, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center	4704224985	MI

General Provider Information

NPI Number	:	1578611224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EARLY SOLUTIONS CLINIC, LLC

Provider Business Mailing Address
First Line	:	2333 S CENTER RD
Second Line	:
City	:	BURTON
State	:	MI
Zip	:	48519-1147
Country	:	US
Telephone Number	:	810-600-1400
Fax Number	:	810-600-1403

Provider Business Practice Location Address
First Line	:	3175 N. ROCHESTER
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48306-1039
Country	:	US
Telephone Number	:	248-853-2900
Fax Number	:	248-853-2906

Authorized Official
Title or Position	:	PRESIDENT AND CEO
Name	:	MRS. JULIET A SANTOS
Credential	:	NURSE PRACTITIONER
Telephone Number	:	810-240-8800

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	08/22/2020

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