Organization
MAINSTREAM SERVICES, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEANA PRINCE (SERVICE COORDINATOR)
(304) 522-1945
Entity
Organization
Contact information
Practice address
4757C ROUTE 152, LAVALETTE, WV 25535-9703
(304) 522-1945
(304) 522-1946
Mailing address
4757C ROUTE 152, LAVALETTE, WV 25535-9703
(304) 522-1945
(304) 522-1946
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
278
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810001125
—
WV
Enumeration date
06/21/2005
Last updated
08/22/2020
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