Provider Demographics
NPI:1114522331
Name:SECURE CARE STAFFING, LLC.
Entity type:Organization
Organization Name:SECURE CARE STAFFING, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMONE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:716-381-0026
Mailing Address - Street 1:229 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14202-2604
Mailing Address - Country:US
Mailing Address - Phone:716-381-0026
Mailing Address - Fax:716-954-7134
Practice Address - Street 1:111 PORTER AVE APT 162
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14201-1025
Practice Address - Country:US
Practice Address - Phone:171-638-1002
Practice Address - Fax:716-954-7134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care