Healthcare Provider Details

I. General information

NPI: 1497862676
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 03/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8043 COOPER CREEK BLVD SUITE 208
UNIVERSITY PARK FL
34201-2142
US

IV. Provider business mailing address

7227 LEE DEFOREST DR
COLUMBIA MD
21046-3236
US

V. Phone/Fax

Practice location:
  • Phone: 941-359-0106
  • Fax:
Mailing address:
  • Phone: 410-910-1500
  • Fax: 410-910-1600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number21416096
License Number StateFL

VIII. Authorized Official

Name: MRS. KATHY JACKSON
Title or Position: REGIONAL VP OF FINANCE
Credential:
Phone: 410-910-1500