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NPI Code Detail

MEDICARE: MAXIM HEALTHCARE SERVICES, INC

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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1134795750
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAXIM HEALTHCARE SERVICES, INC
Provider Business Mailing Address
First Line : 7227 LEE DEFOREST DR
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-3236
Country : US
Telephone Number : 410-910-1500
Fax Number :
Provider Business Practice Location Address
First Line : 7775 BAYMEADOWS WAY STE 200
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32256-7531
Country : US
Telephone Number : 904-396-2199
Fax Number :
Authorized Official
Title or Position : CONTROLLER
Name : DAVID KOWALCZYK
Credential :
Telephone Number : 410-910-1500
Provider Enumeration Date : 06/03/2021
Last Update Date : 04/26/2022

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