Provider Demographics
NPI:1689855173
Name:MAXIMUM SECURITY INC
Entity Type:Organization
Organization Name:MAXIMUM SECURITY INC
Other - Org Name:EARLY LEARNING SOLUTIONS
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER LEAVITT
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:LEAVITT
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:208-760-0407
Mailing Address - Street 1:357 W CENTER ST
Mailing Address - Street 2:SUITE 212
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83204-3236
Mailing Address - Country:US
Mailing Address - Phone:208-760-0407
Mailing Address - Fax:804-915-9440
Practice Address - Street 1:357 W CENTER ST
Practice Address - Street 2:SUITE 212
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83204-3236
Practice Address - Country:US
Practice Address - Phone:208-760-0407
Practice Address - Fax:804-915-9440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No305S00000XManaged Care OrganizationsPoint of Service