Organization
MAXTON AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESTHER IDOWU REGISTERED NURSE (OWNER)
(612) 735-1096
Entity
Organization
Contact information
Practice address
1120 112TH LN NE, BLAINE, MN 55434-4547
(612) 735-1096
(612) 238-0090
Mailing address
1120 112TH LN NE, BLAINE, MN 55434-4547
(612) 735-1096
(612) 238-0090
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253J00000X
Foster Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
273R00000X
Psychiatric Hospital Unit
—
—
310400000X
Assisted Living Facility
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
315D00000X
Inpatient Hospice
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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