Organization Active NPI

Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Portland, ME
National Provider Identifier
1073607743
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
02700 Issued in ME
Legal business name
MAXIM HEALTHCARE SERVICES, INC.
Practice address
1685 Congress St Ste 201
Portland, ME 04102-2149
Phone
(207) 822-4010
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David Kowalczyk
Title
Regional VP of Finance
Phone
(410) 910-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 02700 ME Primary

Addresses

Primary practice location

1685 Congress St Ste 201
Portland, ME 04102-2149

Mailing address

7227 Lee Deforest Dr
Columbia, MD 21046

Other practice location 1

778 Main St
Unit 11
South Portland, ME 04106-5447
Phone (207) 822-4010

Other identifiers 1

IdentifierTypeStateIssuer
176620000MedicaidME

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0984429Maxim Healthcare Services Inc1685 Congress St, Ste 201, Portland, ME 04102Certificate of waiverMar 20, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1073607743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1685 CONGRESS ST STE 201",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022149",
            "telephone_number": "207-822-4010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "778 Main St",
            "address_2": "Unit 11",
            "address_purpose": "LOCATION",
            "city": "South Portland",
            "state": "ME",
            "postal_code": "041065447",
            "country_code": "US",
            "telephone_number": "207-822-4010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "REGIONAL VP OF FINANCE",
        "authorized_official_telephone_number": "410-910-1500"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "ME",
            "license": "02700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176620000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.