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General NPI Number Information
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NPI Number | 1922355593
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Entity Type | Organization
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Legal Business Name | MAXIN HEALTH CARE SERVICES INC.
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Dates
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Enumeration Date | 08/13/2012
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Last Update Date | 08/13/2012
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Provider Practice Location Address
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Address Line | 13508 ARCTURUS AVE. GARDENA CA 90249 3756 SANTA ROSALIA DRIVE SUITE 326A
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City | LOS ANGELES
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State | CA
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Zip | 90008
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Country | US
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Telephone | 323-290-1360
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Fax | 323-290-9721
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Provider Business Mailing Address
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Address Line | 13508 ARCTURUS AVE. GARDENA CA 90249 3756 SANTA ROSALIA DRIVE SUITE 326A
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City | LOS ANGELES
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State | CA
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Zip | 90008
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Country | US
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Telephone | 323-290-1360
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Fax | 323-290-9721
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Authorized Official
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Title or Position | CEO
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Name | MR. MARCEL CHIDI NJOKU
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Credential | RECOVERY CARE
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Telephone | 323-290-1360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 190591AN
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License Number State | CA
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