Maxim Healthcare Services, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

25000766 Issued in CA

Legal business name

MAXIM HEALTHCARE SERVICES, INC.

Practice address

27555 Ynez Rd Ste 300
Temecula, CA 92591-4678

Phone

(951) 694-0100

Fax

(951) 694-0200

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

David Kowalczyk

Title

Regional Controller

Phone

(410) 910-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Home health agency certification: CCN 05K132

Legal name

Maxim Healthcare Services, Inc

Certification status

Active

Provider type (POS)

Home health agency

Participating since

May 24, 2002

Last certification

May 24, 2002

Facility address

27555 Ynez Road
Temecula, CA 92591

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1518040765",
    "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": "21046",
            "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": "27555 YNEZ RD STE 300",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925914678",
            "telephone_number": "951-694-0100",
            "fax_number": "951-694-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIM HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "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"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "CA",
            "license": "25000766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HHA70302F/05-K079",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aubree Matthews
• Garrett Matthews
• Akanksha Maurya
• Andre David Maxie, LMFT
• Maxim Healthcare Services, Inc.
• Frank Maxson, RBT
• Ariana Maxwell
• Denise Marie Maxwell, D.C.
• Tiffany Maxwell
• Stacey Jean Mayerchik

• Home Health Agency in Temecula, CA
• Providers in Temecula, 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 Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.