Organization
MAINSTREAM MEDIA GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELLE THRASHER (ADMINISTRATIVE ASSISTANT)
(248) 943-4107
Entity
Organization
Contact information
Practice address
5000 TOWN CTR, 2405, SOUTHFIELD, MI 48075-1110
(248) 943-4107
Mailing address
5000 TOWN CTR, 2405, SOUTHFIELD, MI 48075-1110
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
12/20/2016
Last updated
12/20/2016
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