NPIMap

Organization Active NPI

Maxim Healthcare Services, Inc.

  • Home Health Agency
  • Mentor, OH
National Provider Identifier
1124298609
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MAXIM HEALTHCARE SERVICES, INC.
Practice address
8641 Tyler Blvd
Mentor, OH 44060-4346
Phone
(440) 352-0137
NPI assigned
Mar 11, 2008
Last updated
Oct 1, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Authorized official

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary
Respite Care 385H00000X NU
In Home Supportive Care Agency 253Z00000X NU

Addresses

Primary practice location

8641 Tyler Blvd
Mentor, OH 44060-4346

Mailing address

7227 Lee Deforest Dr
Columbia, MD 21046-3236
Phone (410) 910-1500

Other practice location 1

70 W Erie St
Suite 200
Painesville, OH 44077-3229
Phone (216) 514-9700

Other practice location 2

8641 Gateway Dr
Suite 100
Mentor, OH 44060
Phone (440) 352-0137

Other identifiers 1

IdentifierTypeStateIssuer
2965340MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080815000110 OH Part A Provider - Home Health Agency 1658288410 Practice locations: Mentor, OH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124298609. Details of each certification follow.

Home health agency certification: CCN 368258

Legal name
MAXIM HEALTHCARE SERVICES INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Feb 13, 2009
Last certification
Feb 1, 2018
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Sep 1, 1988 in MD
Enrollment address
8641 Tyler Blvd
Mentor, OH 44060-4346

Care Compare: Home health agency

Medicare Care Compare
Listed as
Maxim Healthcare Services, IncCCN 368258 · All quality measures
Ownership
Proprietary
Certified
Feb 13, 2009
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
36D1083385Maxim Healthcare Services, Inc8641 Tyler Blvd, Mentor, OH 44060Certificate of waiverApr 30, 2028

National Provider Directory

National Provider Directory
Tax ID family
Maxim Health Systems337 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

8641 Tyler Blvd
Mentor, OH 44060
Phone (440) 352-0137

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Amelia Monroe Individual W-2 Managing EmployeeAd; Mar 1, 2026
Joseph W Marshall Individual Corporate DirectorBoard Member Jul 1, 2017
Randall D Sones Individual Corporate DirectorBoard Member Aug 25, 2009
Jarrod L Depriest Individual Corporate OfficerPresident Jan 1, 2022
Matthew Sticklin Individual Corporate OfficerCfo Aug 29, 2022
Toni-Jean L Friedman Individual Corporate OfficerVP, General Counsel, Secretary Nov 1, 2009
Christopher P Sipes Individual W-2 Managing EmployeeVP of Finance Aug 1, 2016
Oak Investment Trust Organization, Tampa, FL 5% Or Greater Indirect Ownership Interest Mar 18, 2019 38.89%
Stephen J Bisciotti Individual 5% Or Greater Indirect Ownership Interest Mar 18, 2019 19.94%
Oak Investment Trust II Organization, Tampa, FL 5% Or Greater Indirect Ownership Interest Mar 18, 2019 39.35%
Maxim Healthcare Services Holdings, Inc. Organization, Columbia, MD Corporation, Holding company, For-profit 5% Or Greater Direct Ownership Interest Mar 18, 2019 100%

All facility ownership & control disclosures 27

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Maxim Healthcare Services IncPueblo, CO, CCN 067413 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncPoland, OH, CCN 368042 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncPittsburgh, PA, CCN 397783 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncTucson, AZ, CCN 037228 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncSandy, UT, CCN 467212 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncBedford, NH, CCN 307085 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncHarrisburg, PA, CCN 397789 Home health agency Other Jan 9, 2006
Maxim Healthcare Services, Inc.Miamisburg, OH, CCN 368006 Home health agency Other Jan 9, 1996
Maxim Healthcare Services IncPlains, PA, CCN 398016 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncPhoenix, AZ, CCN 037242 Home health agency Other (100%) Apr 25, 2006
Maxim Healthcare Services IncMadison, WI, CCN 527290 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncCanton, OH, CCN 368007 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncToledo, OH, CCN 367799 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncReno, NV, CCN 297049 Home health agency Other (100%) Jan 9, 2006
Maxim Healthcare Services IncOxnard, CA, CCN 058352 Home health agency Other Jan 30, 2006
Maxim Healthcare Services IncAnchorage, AK, CCN 027032 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncFresno, CA, CCN 058323 Home health agency Other Jan 9, 2006
Maxim Healthcare Services IncLas Vegas, NV, CCN 297085 Home health agency Other (100%) Sep 2, 1988
Maxim Healthcare Services IncAllentown, PA, CCN 398065 Home health agency Other (100%) Jun 1, 2007
Maxim Healthcare Services IncColorado Springs, CO, CCN 067325 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncLa Junta, CO, CCN 067466 Home health agency Other (100%) Feb 10, 2012
Maxim Healthcare Services IncSan Luis Obispo, CA, CCN 059129 Home health agency Other (100%) Dec 4, 2009
Maxim Healthcare Services IncRoseville, CA, CCN 059117 Home health agency Operational/Managerial Control (100%) Jan 1, 2009
Maxim Healthcare Services IncYork, PA, CCN 398132 Home health agency Other (100%) Apr 28, 2010
Maxim Healthcare Services IncEvansville, IN, CCN 157680 Home health agency Other (100%) Jun 30, 2011
Maxim Healthcare Services IncCrown Point, IN, CCN 157679 Home health agency Other (100%) Jun 30, 2011
Maxim Healthcare Services IncLos Angeles, CA, CCN 053198 Home health agency Other (100%) Jun 30, 2011

Facilities with the same owner 69

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 69

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790812800000",
    "number": "1124298609",
    "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": "210463236",
            "telephone_number": "410-910-1500",
            "fax_number": "410-910-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8641 TYLER BLVD",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440604346",
            "telephone_number": "440-352-0137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "70 W Erie St",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Painesville",
            "state": "OH",
            "postal_code": "440773229",
            "country_code": "US",
            "telephone_number": "216-514-9700",
            "fax_number": "216-514-8315",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8641 Gateway Dr",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Mentor",
            "state": "OH",
            "postal_code": "44060",
            "country_code": "US",
            "telephone_number": "440-352-0137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "410-910-1500"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2965340",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mentor, OH

Sources for this page

Verify at the official NPI Registry.