Healthcare Provider Details

I. General information

NPI: 1215252879
Provider Name (Legal Business Name): MAXIMUM HOMECARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 02/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1577 NEVADA AVE E
SAINT PAUL MN
55106-1526
US

IV. Provider business mailing address

1577 NEVADA AVE E
SAINT PAUL MN
55106-1526
US

V. Phone/Fax

Practice location:
  • Phone: 651-353-8964
  • Fax:
Mailing address:
  • Phone: 651-353-8964
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number346138
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number346138
License Number StateMN

VIII. Authorized Official

Name: MRS. MERCY ADENIKE AJAYI
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 651-353-8964