Provider Demographics
NPI:1871635706
Name:FIRSTSOLUTIONS
Entity Type:Organization
Organization Name:FIRSTSOLUTIONS
Other - Org Name:SUPERIORHEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:JACOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:2187-400-2330
Mailing Address - Street 1:1502 LONDON RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55812-1788
Mailing Address - Country:US
Mailing Address - Phone:218-727-8228
Mailing Address - Fax:218-733-1325
Practice Address - Street 1:1502 LONDON RD
Practice Address - Street 2:SUITE 102
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55812-1788
Practice Address - Country:US
Practice Address - Phone:218-727-8228
Practice Address - Fax:218-733-1325
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FIRSTSOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-14
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN24D0404121291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory