Provider Demographics
NPI: | 1033009758 |
---|---|
Name: | MAXIMUM FAMILY CARE LLC |
Entity type: | Organization |
Organization Name: | MAXIMUM FAMILY CARE LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MERNOY |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | HARRISON |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 602-921-5466 |
Mailing Address - Street 1: | 3823 E HIDDENVIEW DR |
Mailing Address - Street 2: | |
Mailing Address - City: | PHOENIX |
Mailing Address - State: | AZ |
Mailing Address - Zip Code: | 85048-7371 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 602-921-5466 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 4701 S LAKESHORE DR STE 1 |
Practice Address - Street 2: | |
Practice Address - City: | TEMPE |
Practice Address - State: | AZ |
Practice Address - Zip Code: | 85282-7169 |
Practice Address - Country: | US |
Practice Address - Phone: | 602-921-5466 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2025-07-04 |
Last Update Date: | 2025-07-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 224ZE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Environmental Modification | Group - Multi-Specialty |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 225A00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Music Therapist | Group - Multi-Specialty | |
No | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Multi-Specialty |
No | 225XR0403X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Driving and Community Mobility | Group - Multi-Specialty |
No | 2355S0801X | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant | Group - Multi-Specialty |
No | 261QH0700X | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech | |
No | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | |
No | 261QX0100X | Ambulatory Health Care Facilities | Clinic/Center | Occupational Medicine | |
No | 347E00000X | Transportation Services | Transportation Broker |