Provider Demographics
NPI:1104986280
Name:MAXIM HEALTHCARE SRVICES
Entity type:Organization
Organization Name:MAXIM HEALTHCARE SRVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-674-3331
Mailing Address - Street 1:72750 EL PASEO STE C-1
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-3301
Mailing Address - Country:US
Mailing Address - Phone:760-674-3331
Mailing Address - Fax:760-674-8811
Practice Address - Street 1:73750 EL PASEO STE C-1
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-4323
Practice Address - Country:US
Practice Address - Phone:760-674-3331
Practice Address - Fax:760-674-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHHA70309F251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health