Provider Demographics
NPI:1568035608
Name:MAXLIVING HOME CARE SERVICES, LLC
Entity Type:Organization
Organization Name:MAXLIVING HOME CARE SERVICES, LLC
Other - Org Name:MAXLIVING HOME CARE SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:FARAH
Authorized Official - Last Name:BOTAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-843-2744
Mailing Address - Street 1:519 UNIVERSITY AVE W STE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55103-2161
Mailing Address - Country:US
Mailing Address - Phone:763-843-2744
Mailing Address - Fax:612-416-0151
Practice Address - Street 1:519 UNIVERSITY AVE W STE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55103-2161
Practice Address - Country:US
Practice Address - Phone:763-843-2744
Practice Address - Fax:612-416-0151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-16
Last Update Date:2022-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health