Healthcare Provider Details
I. General information
NPI: 1376116509
Provider Name (Legal Business Name): MAXIMUM SUPPORT MENTAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/24/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7125 THOMAS EDISON DR STE 200
COLUMBIA MD
21046-2978
US
IV. Provider business mailing address
7125 THOMAS EDISON DR STE 200
COLUMBIA MD
21046-2978
US
V. Phone/Fax
- Phone: 302-750-2837
- Fax:
- Phone: 302-750-2837
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
OLUKAYODE
ADELEYE
Title or Position: PRESIDENT/ CEO
Credential:
Phone: 302-750-2837