Provider Demographics
NPI:1699299982
Name:MAXIMUM PERFORMANCE, INC.
Entity type:Organization
Organization Name:MAXIMUM PERFORMANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEHNS
Authorized Official - Middle Name:SILVA
Authorized Official - Last Name:GONCALVES
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW, EDD
Authorized Official - Phone:734-677-0200
Mailing Address - Street 1:2195 ARDENNE DRIVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105
Mailing Address - Country:US
Mailing Address - Phone:734-677-0200
Mailing Address - Fax:734-677-3310
Practice Address - Street 1:2725 PACKARD ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108
Practice Address - Country:US
Practice Address - Phone:734-677-0200
Practice Address - Fax:734-677-3310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-28
Last Update Date:2017-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010188041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty