Healthcare Provider Details

I. General information

NPI: 1164486304
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 08/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 WILDWOOD FOREST DR STE 200N
SPRING TX
77380
US

IV. Provider business mailing address

7227 LEE DEFOREST DRIVE
COLUMBIA MD
21046-3405
US

V. Phone/Fax

Practice location:
  • Phone: 832-458-3793
  • 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 Number7759
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DAVID KOWALCZYK
Title or Position: REGIONAL VP OF FINANCE
Credential:
Phone: 410-910-1500