Provider Demographics
NPI:1871881102
Name:SECURE HOME CARE, LLC
Entity type:Organization
Organization Name:SECURE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HICKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-618-4248
Mailing Address - Street 1:40 J C WATTS AVE
Mailing Address - Street 2:
Mailing Address - City:EUFAULA
Mailing Address - State:OK
Mailing Address - Zip Code:74432-3010
Mailing Address - Country:US
Mailing Address - Phone:918-618-4248
Mailing Address - Fax:918-618-4473
Practice Address - Street 1:40 J C WATTS AVE
Practice Address - Street 2:
Practice Address - City:EUFAULA
Practice Address - State:OK
Practice Address - Zip Code:74432-3010
Practice Address - Country:US
Practice Address - Phone:918-618-4248
Practice Address - Fax:918-618-4473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKHC7968251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health