Organization
MAINSTREAM AUTISM SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH BANUA (OWNER/CEO)
(615) 939-8049
Entity
Organization
Contact information
Practice address
103 S HIGH RIDGE DR, GOODLETTSVILLE, TN 37072-7085
(615) 939-8049
Mailing address
103 S HIGH RIDGE DR, GOODLETTSVILLE, TN 37072-7085
(615) 939-8049
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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