Organization
MAXIM HEALTHCARE SERVICES, INC.
Active
Organization
MAXIM HEALTHCARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KOWALCZYK (CONTROLLER)
(410) 910-1500
Entity
Organization
Contact information
Practice address
1801 PARK 270 DR STE 550, SAINT LOUIS, MO 63146-4016
(314) 569-3935
(314) 569-3305
Mailing address
7227 LEE DEFOREST DR, COLUMBIA, MD 21046-3236
(410) 910-1500
(410) 910-1600
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
858103609
—
MO
Enumeration date
05/09/2008
Last updated
05/11/2023
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