Maxim Healthcare Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

60000547 Issued in CA

Legal business name

MAXIM HEALTHCARE SERVICES, INC.

Practice address

23421 S Pointe Dr Ste 200
Laguna Hills, CA 92653

Phone

(949) 770-4994

NPI assigned

Jul 8, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David S. Kowalczyk

Title

VP of Finance

Phone

(410) 910-1730

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534291200000",
    "number": "1497788137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7227 LEE DEFOREST DRIVE",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210463405",
            "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": "23421 S POINTE DR STE 200",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "92653",
            "telephone_number": "949-770-4994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25332 Cabot Rd",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Laguna Hills",
            "state": "CA",
            "postal_code": "926535521",
            "country_code": "US",
            "telephone_number": "949-770-4994",
            "fax_number": "949-770-4884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2018-08-15",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "410-910-1730",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "60000547",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA70298F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Laguna Hills, CA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.