Provider Demographics
NPI:1972892206
Name:MAXUS INC.
Entity type:Organization
Organization Name:MAXUS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:SUHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-647-1400
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:72478-9077
Mailing Address - Country:US
Mailing Address - Phone:870-647-1400
Mailing Address - Fax:870-647-2337
Practice Address - Street 1:316 MAIN STREET
Practice Address - Street 2:
Practice Address - City:LAKE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71653
Practice Address - Country:US
Practice Address - Phone:870-265-2186
Practice Address - Fax:870-265-2305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty