Provider Demographics
NPI:1619396546
Name:RESOLUTION SOURCE LLC
Entity Type:Organization
Organization Name:RESOLUTION SOURCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOTIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-693-3546
Mailing Address - Street 1:2020 BUSINESS CENTER DR APT 10102
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0079
Mailing Address - Country:US
Mailing Address - Phone:972-693-3546
Mailing Address - Fax:
Practice Address - Street 1:2020 BUSINESS CENTER DR APT 10102
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-0079
Practice Address - Country:US
Practice Address - Phone:972-693-3546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No347E00000XTransportation ServicesTransportation Broker