Provider Demographics
NPI:1215737127
Name:SECURE HOUSING LLC
Entity type:Organization
Organization Name:SECURE HOUSING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:BURPEE
Authorized Official - Suffix:
Authorized Official - Credentials:ALA
Authorized Official - Phone:208-221-4721
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:ID
Mailing Address - Zip Code:83355-0306
Mailing Address - Country:US
Mailing Address - Phone:208-221-4721
Mailing Address - Fax:208-536-5570
Practice Address - Street 1:210 N IDAHO ST
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:ID
Practice Address - Zip Code:83355-5037
Practice Address - Country:US
Practice Address - Phone:208-221-4721
Practice Address - Fax:208-536-5570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness