NPIMap

Organization Active NPI

Maxim Habilitation Services, LLC

  • Developmentally Disabled Services Day Training Agency
  • Jacksonville, NC
National Provider Identifier
1235325358
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
MAXIM HABILITATION SERVICES, LLC
Practice address
825 Gum Branch Rd
Suite 112
Jacksonville, NC 28540-6298
Phone
(910) 355-2757
NPI assigned
Sep 21, 2007
Last updated
Sep 21, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

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

Authorized official

Name
Mr. Jeremy Smith
Title
Controller
Phone
(410) 910-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X NU Primary

Addresses

Primary practice location

825 Gum Branch Rd
Suite 112
Jacksonville, NC 28540-6298

Mailing address

7227 Lee Deforest Dr
Columbia, MD 21046-3236

National Provider Directory

National Provider Directory
Tax ID family
Maxim Habilitation Services LLC23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Locations

825 Gum Branch Rd
Ste 112
Jacksonville, NC 28540
Phone (910) 355-2757

NPI Registry JSON

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1235325358",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 GUM BRANCH RD",
            "address_2": "SUITE 112",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285406298",
            "telephone_number": "910-355-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HABILITATION SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "410-910-1500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.