Provider Demographics
NPI:1801412705
Name:MAXI HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:MAXI HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:AZUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-356-7597
Mailing Address - Street 1:1069 LAKEFIELD WALK
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5758
Mailing Address - Country:US
Mailing Address - Phone:770-356-7597
Mailing Address - Fax:
Practice Address - Street 1:2453 POWDER SPRINGS RD SW STE 220B
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4570
Practice Address - Country:US
Practice Address - Phone:770-356-7597
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care