Healthcare Provider Details

I. General information

NPI: 1043163371
Provider Name (Legal Business Name): SECURED HEALTH AND HOMECARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2026
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 REGENT AVE N
BROOKLYN PARK MN
55443-3348
US

IV. Provider business mailing address

4519 104TH AVE N
BROOKLYN PARK MN
55443-1030
US

V. Phone/Fax

Practice location:
  • Phone: 763-438-8869
  • Fax: 763-438-8869
Mailing address:
  • Phone: 763-438-8869
  • Fax: 763-438-8869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State

VIII. Authorized Official

Name: ABIOLA IJADIMBOLA
Title or Position: OWNER/OPERATION DIRECTOR
Credential:
Phone: 763-438-8869