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General NPI Number Information
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NPI Number | 1215252879
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Entity Type | Organization
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Legal Business Name | MAXIMUM HOMECARE SERVICES LLC
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Dates
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Enumeration Date | 04/06/2010
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 1577 NEVADA AVE E
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City | SAINT PAUL
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State | MN
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Zip | 55106-1526
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Country | US
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Telephone | 651-353-8964
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Fax |
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Provider Business Mailing Address
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Address Line | 1577 NEVADA AVE E
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City | SAINT PAUL
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State | MN
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Zip | 55106-1526
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Country | US
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Telephone | 651-353-8964
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. MERCY ADENIKE AJAYI
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Credential | RN
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Telephone | 651-353-8964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 346138
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 346138
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License Number State | MN
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