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General NPI Number Information
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NPI Number | 1376046797
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Entity Type | Organization
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Legal Business Name | SECURE HOME HEALTH AGENCY INC.
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Dates
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Enumeration Date | 03/12/2018
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Last Update Date | 08/18/2023
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Provider Practice Location Address
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Address Line | 4 SALLY DR REAR
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-3416
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Country | US
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Telephone | 314-733-5125
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Fax | 314-754-9767
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Provider Business Mailing Address
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Address Line | 4 SALLY DR REAR
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City | MARYLAND HEIGHTS
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State | MO
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Zip | 63043-3416
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Country | US
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Telephone | 314-733-5125
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Fax | 314-754-9767
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Authorized Official
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Title or Position | CEO/OWNER
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Name | MARGUERITE RANDALL
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Credential |
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Telephone | 314-733-5125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 13-39098-102
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 001009
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License Number State | MO
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