Provider Demographics
NPI:1841686482
Name:MAXIM HEALTH CARE
Entity type:Organization
Organization Name:MAXIM HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PRACTICAL NURSE
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:585-317-1203
Mailing Address - Street 1:226 MILFORD ST
Mailing Address - Street 2:19
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-1879
Mailing Address - Country:US
Mailing Address - Phone:585-317-1203
Mailing Address - Fax:
Practice Address - Street 1:151 STATE ST
Practice Address - Street 2:100
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14614
Practice Address - Country:US
Practice Address - Phone:585-454-3550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-10
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316959251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health