MEDICARE: MAXUS HEALTHCARE PARTNERS LLC

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	253Z00000X	In Home Supportive Care Agency		TX

General Provider Information

NPI Number	:	1043694094
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MAXUS HEALTHCARE PARTNERS LLC

Provider Business Mailing Address
First Line	:	1021 WASHINGTON AVE STE 201
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3021
Country	:	US
Telephone Number	:	817-769-8296
Fax Number	:	817-796-1285

Provider Business Practice Location Address
First Line	:	1021 WASHINGTON AVE STE 201
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-3021
Country	:	US
Telephone Number	:	817-769-8296
Fax Number	:	817-796-1285

Authorized Official
Title or Position	:	VP
Name	:	FREDA KELLEY
Credential	:
Telephone Number	:	806-340-8176

Provider Enumeration Date	:	07/18/2015
Last Update Date	:	11/13/2025

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