Healthcare Provider Details

I. General information

NPI: 1316781933
Provider Name (Legal Business Name): SECURED HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2024
Last Update Date: 02/16/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1667 CANTON RD STE B
MARIETTA GA
30066-6491
US

IV. Provider business mailing address

1667 CANTON RD STE B
MARIETTA GA
30066-6491
US

V. Phone/Fax

Practice location:
  • Phone: 404-667-0255
  • Fax: 877-570-2351
Mailing address:
  • Phone: 404-667-0255
  • Fax: 877-570-2351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: PAMELA IBISO OBENOFUNDE
Title or Position: MANAGER
Credential:
Phone: 404-667-0255