Healthcare Provider Details

I. General information

NPI: 1811387301
Provider Name (Legal Business Name): SECURA HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2015
Last Update Date: 02/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

754 ROUTE 18
EAST BRUNSWICK NJ
08816-4909
US

IV. Provider business mailing address

611 ROUTE 46 W SUITE 200
HASBROUCK HEIGHTS NJ
07604-3118
US

V. Phone/Fax

Practice location:
  • Phone: 732-390-1630
  • Fax:
Mailing address:
  • Phone: 201-403-9300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DONNA LODATO
Title or Position: PRESIDENT
Credential:
Phone: 201-403-9300