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General NPI Number Information
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NPI Number | 1104986280
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Entity Type | Organization
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Legal Business Name | MAXIM HEALTHCARE SRVICES
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 73750 EL PASEO STE C-1
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City | PALM DESERT
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State | CA
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Zip | 92260-4323
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Country | US
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Telephone | 760-674-3331
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Fax | 760-674-8811
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Provider Business Mailing Address
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Address Line | 72750 EL PASEO STE C-1
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City | PALM DESERT
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State | CA
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Zip | 92260-3301
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Country | US
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Telephone | 760-674-3331
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Fax | 760-674-8811
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Authorized Official
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Title or Position | ACCOUNTS MANAGER
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Name | DARIAN SALAZAR
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Credential |
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Telephone | 760-674-3331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA70309F
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License Number State | CA
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