Provider Demographics
NPI:1497760201
Name:HEALTH MAX GROUP, LLC
Entity Type:Organization
Organization Name:HEALTH MAX GROUP, LLC
Other - Org Name:AMERICAN PREMIER HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:JUSTIMBASTE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:623-206-7386
Mailing Address - Street 1:11070 N 24TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85029-4705
Mailing Address - Country:US
Mailing Address - Phone:602-287-0003
Mailing Address - Fax:602-287-0005
Practice Address - Street 1:11070 N 24TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85029-4705
Practice Address - Country:US
Practice Address - Phone:602-287-0003
Practice Address - Fax:602-287-0005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA3574251E00000X
AZ251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ957657Medicaid
037232Medicare UPIN
AZ037232Medicare ID - Type UnspecifiedHOME HEALTH AGENCY