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General NPI Number Information
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NPI Number | 1720011638
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Entity Type | Organization
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Legal Business Name | MAXIM HEALTHCARE SERVICES, INC.
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 08/22/2013
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Provider Practice Location Address
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Address Line | 9655 SE 36TH ST SUITE 210
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City | MERCER ISLAND
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State | WA
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Zip | 98040-3798
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Country | US
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Telephone | 206-985-4625
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Fax | 206-527-5636
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Provider Business Mailing Address
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Address Line | 7227 LEE DEFOREST DRIVE
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City | COLUMBIA
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State | MD
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Zip | 21046-3405
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Country | US
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Telephone | 410-910-1500
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Fax | 410-910-1600
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Authorized Official
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Title or Position | REGIONAL CONTROLLER
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Name | MR. DAVID S. KOWALCZYK
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Credential |
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Telephone | 410-910-1730
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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 |
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License Number State |
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