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General NPI Number Information
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NPI Number | 1134475825
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Entity Type | Organization
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Legal Business Name | MAXIM HEALTH CARE
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 08/08/2012
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Provider Practice Location Address
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Address Line | 5200 S ULSTER ST 1503
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2861
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Country | US
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Telephone | 719-440-2936
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 S ULSTER ST 1503
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-2861
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Country | US
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Telephone | 719-440-2936
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH TECHNICIAN
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Name | ABIGAIL SCHREIBER
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Credential | BA
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Telephone | 719-440-2936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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