| Organization Name: | MAXIM HEALTHCARE SERVICES, INC. |
| NPI Number: | 1003027012 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID KOWALCZYK (REGIONAL CONTROLLER) |
| Mailing Address: | 5066 N Fresno St Suite 103 Fresno |
| State: | CA US |
| Postal Code: | 937107615 |
| Phone Number: | 5592272250 |
| Fax Number: | 5592271481 |
| NPI Enumeration Date: | 05/24/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |