Organization
MAXIM HEALTHCARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID S KOWALCZYK (REGIONAL CONTROLLER)
(410) 910-1500
Entity
Organization
Contact information
Practice address
2155 LOUISIANA BLVD NE, SUITE 5100, ALBUQUERQUE, NM 87110-5409
(505) 883-4444
(505) 883-9788
Mailing address
7227 LEE DEFOREST DRIVE, COLUMBIA, MD 21046-3405
(410) 910-1500
(410) 910-1600
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
IT3059
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53154771
—
NM
05
—
A0637
—
NM
Enumeration date
05/19/2006
Last updated
10/19/2009
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