Provider Demographics
NPI:1083418099
Name:SECURED HOME CARE AGENCY LLC
Entity type:Organization
Organization Name:SECURED HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARENA
Authorized Official - Middle Name:KING
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-229-3695
Mailing Address - Street 1:3388 DUNN RD STE A
Mailing Address - Street 2:
Mailing Address - City:EASTOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28312-8798
Mailing Address - Country:US
Mailing Address - Phone:910-229-3695
Mailing Address - Fax:910-229-3615
Practice Address - Street 1:3388 DUNN RD STE A
Practice Address - Street 2:
Practice Address - City:EASTOVER
Practice Address - State:NC
Practice Address - Zip Code:28312-8798
Practice Address - Country:US
Practice Address - Phone:910-229-3695
Practice Address - Fax:910-229-3615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-01
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health