Healthcare Provider Details

I. General information

NPI: 1871680256
Provider Name (Legal Business Name): MAXIM HEALTHCARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 09/25/2024
Certification Date: 09/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2522 OAK MANOR WAY
TYLER TX
75703-8398
US

IV. Provider business mailing address

7227 LEE DEFOREST DRIVE
COLUMBIA MD
21046
US

V. Phone/Fax

Practice location:
  • Phone: 903-581-8881
  • Fax: 877-799-3230
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 Number10128
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