Organization
MAXCARE HEALTH AND RESIDENTIAL SERVICES LLC
Active
Organization
MAXCARE HEALTH AND RESIDENTIAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MELVIN MAX OLIVER (PROGRAM DIRECTOR)
(804) 366-7605
Entity
Organization
Contact information
Practice address
13900 CEDAR CREEK RD, CHESTERFIELD, VA 23838
(804) 739-5902
Mailing address
13900 CEDAR CREEK RD, CHESTERFIELD, VA 23838-1216
(804) 739-5902
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
2723
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2723-01-001
—
VA
Enumeration date
09/18/2017
Last updated
07/21/2022
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