Provider Demographics
NPI:1730464868
Name:THE SOLUTION SOURCE, LLC.
Entity Type:Organization
Organization Name:THE SOLUTION SOURCE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICIAN/UTILIZATION REVIEW
Authorized Official - Prefix:MRS
Authorized Official - First Name:AZMAT
Authorized Official - Middle Name:
Authorized Official - Last Name:MOINUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-525-0391
Mailing Address - Street 1:4038 GAP RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-5903
Mailing Address - Country:US
Mailing Address - Phone:865-525-0391
Mailing Address - Fax:
Practice Address - Street 1:22510 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-3802
Practice Address - Country:US
Practice Address - Phone:423-569-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health