Provider Demographics
NPI:1285027961
Name:MAXCARE LLC
Entity Type:Organization
Organization Name:MAXCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:NGWU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-498-7700
Mailing Address - Street 1:15 WILLIAMS AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-2325
Mailing Address - Country:US
Mailing Address - Phone:718-498-7700
Mailing Address - Fax:718-498-7701
Practice Address - Street 1:15 WILLIAMS AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-2325
Practice Address - Country:US
Practice Address - Phone:718-498-7700
Practice Address - Fax:718-498-7701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2049-L251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care