| Name: | Maxim Healthcare Services, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 04 Aug 1997 (27 years ago) |
| Identification Number: | 000096242 |
| Place of Formation: | MARYLAND |
| Principal Address: | 7227 LEE DEFOREST DRIVE, COLUMBIA, MD, 21046-3236, USA |
| Purpose: | HOME HEALTH CARE SERVICES |
| NAICS: | 621610 - Home Health Care Services |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649382151 | 2006-08-31 | 2023-06-07 | 7227 LEE DEFOREST DR, COLUMBIA, MD, 210463236, US | 1 CEDAR ST STE 101, PROVIDENCE, RI, 029031023, US | |||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 410-910-1500 |
| Fax | 4109101600 |
| Phone | +1 401-751-6333 |
Authorized person
| Name | DAVID KOWALCZYK |
| Role | CONTROLLER |
| Phone | 4109101500 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 2271 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 251J00000X - Nursing Care Agency |
| License Number | 2271 |
| State | RI |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | MH34515 |
| State | RI |
| Issuer | MEDICAID |
| Number | MH343271 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| PRENTICE-HALL CORP SYSTEM | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| TONI-JEAN LISA | SECRETARY | 7227 LEE DEFOREST DR COLUMBIA, MD 21046-3236 USA |
| Name | Role | Address |
|---|---|---|
| JARROD DEPRIEST | PRESIDENT | 7227 LEE DEFOREST DRIVE COLUMBIA, MD 21046-3236 USA |
| Name | Role | Address |
|---|---|---|
| MATTHEW STICKLIN | TREASURER | 7227 LEE DEFOREST DR COLUMBIA, MD 21046-3236 USA |
| Name | Role | Address |
|---|---|---|
| WILLIAM BUTZ | DIRECTOR | 7227 LEE DEFOREST DR COLUMBIA, MD 21046-3236 USA |
| JOSEPH MARSHALL | DIRECTOR | 7227 LEE DEFOREST DR COLUMBIA, MD 21046-3236 USA |
| RANDALL SONES | DIRECTOR | 7227 LEE DEFOREST DR COLUMBIA, MD 21046-3236 USA |
| JAMES DAVIS | DIRECTOR | 7227 LEE DEFOREST DR COLUMBIA, MD 21046-3236 USA |
| Number | Name | File Date |
|---|---|---|
| 202445828250 | Annual Report | 2024-02-07 |
| 202327491440 | Annual Report | 2023-02-03 |
| 202207718850 | Annual Report | 2022-01-06 |
| 202184024780 | Annual Report | 2021-01-04 |
| 202034991330 | Annual Report | 2020-02-24 |
| 201882902860 | Annual Report | 2018-12-19 |
| 201856014180 | Annual Report | 2018-01-10 |
| 201737870610 | Annual Report | 2017-03-10 |
| 201695298860 | Annual Report | 2016-03-28 |
| 201555358710 | Annual Report | 2015-02-19 |
Date of last update: 08 Oct 2024
Sources: Rhode Island Department of State
