Healthcare Provider Details

I. General information

NPI: 1518357011
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

6406 BERGENLINE AVE
WEST NEW YORK NJ
07093-1634
US

IV. Provider business mailing address

611 ROUTE 46 WEST SUITE 200
HASBROUCK HEIGHTS NJ
07604
US

V. Phone/Fax

Practice location:
  • Phone: 201-854-5508
  • 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