Provider Demographics
NPI:1407969546
Name:MAXIM HEALTHCARE SERVICES, INC.
Entity Type:Organization
Organization Name:MAXIM HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-910-1500
Mailing Address - Street 1:7227 LEE DEFOREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046
Mailing Address - Country:US
Mailing Address - Phone:410-910-1500
Mailing Address - Fax:410-910-1600
Practice Address - Street 1:30300 TELEGRAPH RD
Practice Address - Street 2:SUITE 280
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4507
Practice Address - Country:US
Practice Address - Phone:248-430-0200
Practice Address - Fax:248-430-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4388004Medicaid