Provider Demographics
NPI:1215111364
Name:MAXUS, INC.
Entity type:Organization
Organization Name:MAXUS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TROUTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-647-2541
Mailing Address - Street 1:1033 OLD BURR RD
Mailing Address - Street 2:
Mailing Address - City:WARM SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:72478
Mailing Address - Country:US
Mailing Address - Phone:870-379-3018
Mailing Address - Fax:
Practice Address - Street 1:416 EAST ANTIOCH
Practice Address - Street 2:
Practice Address - City:DELIGHT
Practice Address - State:AR
Practice Address - Zip Code:71940
Practice Address - Country:US
Practice Address - Phone:870-379-3018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty