# MAINSTREAM MEDIA GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750826236
- **Authorized official:** GABRIELLE THRASHER (ADMINISTRATIVE ASSISTANT)
- **Authorized official phone:** (248) 943-4107

## Contact information

- **Practice address:** 5000 TOWN CTR, 2405, SOUTHFIELD, MI 48075-1110
- **Practice address phone:** (248) 943-4107
- **Mailing address:** 5000 TOWN CTR, 2405, SOUTHFIELD, MI 48075-1110

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 347C00000X | Private Vehicle | — | NULL | — |

## Other

- **Enumeration date:** 12/20/2016
- **Last updated:** 12/20/2016