Healthcare Provider Details
I. General information
NPI: 1164191755
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/08/2021
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2891 CENTER POINTE DR STE 200
FORT MYERS FL
33916-9456
US
IV. Provider business mailing address
7227 LEE DEFOREST DR
COLUMBIA MD
21046-3236
US
V. Phone/Fax
- Phone: 877-774-0533
- Fax:
- Phone: 410-910-1500
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 385H00000X |
| Taxonomy | Respite Care |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
KOWALCZYK
Title or Position: CONTROLLER
Credential:
Phone: 410-910-1500