MEDICARE: MAXIM HEALTHCARE SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency
2	251E00000X	Home Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	012912	OTHER	TX	HOME HEALTH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023105533
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXIM HEALTHCARE SERVICES, INC.

Provider Business Mailing Address
First Line	:	7227 LEE DEFOREST RD
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-3236
Country	:	US
Telephone Number	:	410-910-1500
Fax Number	:	410-910-1600

Provider Business Practice Location Address
First Line	:	1077 WESTHEIMER RD.
Second Line	:	SUITE 955
City	:	HOUSTON
State	:	TX
Zip	:	77042
Country	:	US
Telephone Number	:	832-778-6515
Fax Number	:	877-774-0531

Authorized Official
Title or Position	:	CONTROLLER
Name	:	DAVID KOWALCZYK
Credential	:
Telephone Number	:	410-910-1500

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	06/30/2022

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Directions to “MAXIM HEALTHCARE SERVICES, INC. ” Practice Location

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