MEDICARE: SECURE HOME HEALTH CARE, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1750080123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SECURE HOME HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	10545 BURBANK BLVD STE 123
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2250
Country	:	US
Telephone Number	:	747-946-6010
Fax Number	:	747-946-6011

Provider Business Practice Location Address
First Line	:	10545 BURBANK BLVD STE 123
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-2250
Country	:	US
Telephone Number	:	747-946-6010
Fax Number	:	747-946-6011

Authorized Official
Title or Position	:	CEO
Name	:	VAHAN MANUKYAN
Credential	:
Telephone Number	:	747-946-6010

Provider Enumeration Date	:	02/24/2023
Last Update Date	:	02/24/2023

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