Provider Demographics
NPI:1063529873
Name:REIDSTREETS
Entity type:Organization
Organization Name:REIDSTREETS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:313-617-6088
Mailing Address - Street 1:8541 CANFIELD DRIVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DEABORN HTS.
Mailing Address - State:MI
Mailing Address - Zip Code:48127
Mailing Address - Country:US
Mailing Address - Phone:313-617-6088
Mailing Address - Fax:
Practice Address - Street 1:8541 CANFIELD DRIVE
Practice Address - Street 2:SUITE 204
Practice Address - City:DEABORN HTS.
Practice Address - State:MI
Practice Address - Zip Code:48127
Practice Address - Country:US
Practice Address - Phone:313-617-6088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management