Healthcare Provider Details

I. General information

NPI: 1396098224
Provider Name (Legal Business Name): SECURE CARE FAMILY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5632 WENLOCK ST
LOS ANGELES CA
90016-5035
US

IV. Provider business mailing address

6709 LA TIJERA BOULEVARD, NO. 517
LOS ANGELES CA
90045-2017
US

V. Phone/Fax

Practice location:
  • Phone: 323-638-7237
  • Fax:
Mailing address:
  • Phone: 323-638-7237
  • Fax: 323-488-9734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. LYRIC ARMSTRONG
Title or Position: CHEIF EXECUTIVE OFFICER
Credential:
Phone: 323-638-7237