Maxim Healthcare Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MAXIM HEALTHCARE SERVICES, INC.

Practice address

15095 Amargosa Road
Suite 102
Victorville, CA 92394

Phone

(760) 243-3377

Fax

(760) 243-2366

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Mr. David Kowalczyk

Title

Regional Controller

Phone

(410) 910-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1164604906",
    "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": "15095 AMARGOSA ROAD",
            "address_2": "SUITE 102",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "92394",
            "telephone_number": "760-243-3377",
            "fax_number": "760-243-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "REGIONAL CONTROLLER",
        "authorized_official_telephone_number": "410-910-1500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HOME HEALTH",
            "identifier": "550000847",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clare M Matney, M.D.
• Glenn Paul Matney, M.D.
• Mina Matta, PROVIDER
• Unique Joy Matthews
• Mary Maunglay, M.D.
• Shannon Mayhall
• Kassandra Mayorga
• Jennifer Odessa Mayweather
• Kimberly Mazzarese
• Jessica MC Kenna

• Home Health Agency in Victorville, CA
• Providers in Victorville, CA by specialty
• Home Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.