Provider Demographics
NPI:1083720676
Name:MAXIM HEALTHCARE SERVICES, INC.
Entity type:Organization
Organization Name:MAXIM HEALTHCARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KOWALCZYK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-910-1500
Mailing Address - Street 1:7227 LEE DEFOREST DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-3236
Mailing Address - Country:US
Mailing Address - Phone:410-910-1500
Mailing Address - Fax:410-910-1600
Practice Address - Street 1:26750 US HIGHWAY 19 N STE 400
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-3459
Practice Address - Country:US
Practice Address - Phone:727-524-2727
Practice Address - Fax:727-530-4673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 385H00000X
FL21474096251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL672896196Medicaid
FL672896100Medicaid
FL684808700Medicaid
FL650869300Medicaid
FL001136700Medicaid
FL650869379Medicaid