Provider Demographics
NPI:1245412089
Name:MAXIMA GROUP BEHAVIORAL SERVICES INC
Entity Type:Organization
Organization Name:MAXIMA GROUP BEHAVIORAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BYRON
Authorized Official - Middle Name:L
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-227-9998
Mailing Address - Street 1:1901 WESTBANK EXPY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-4366
Mailing Address - Country:US
Mailing Address - Phone:504-227-9998
Mailing Address - Fax:504-227-0722
Practice Address - Street 1:1901 WESTBANK EXPY
Practice Address - Street 2:SUITE 600
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-4366
Practice Address - Country:US
Practice Address - Phone:504-227-9998
Practice Address - Fax:504-227-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA12506251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1171891Medicaid