=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467494948
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SECURE HOME HEALTH MANAGEMENT, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/11/2006
-----------------------------------------------------
Last Update Date | 12/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1085 INTERSTATE 10 N STE B
-----------------------------------------------------
City | BEAUMONT
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77706-4816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 409-719-0111
-----------------------------------------------------
Fax | 409-719-0110
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6760 OLD JACKSONVILLE HWY STE 101
-----------------------------------------------------
City | TYLER
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75703-0566
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 855-485-8273
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CHIEF GROWTH OFFICER
-----------------------------------------------------
Name | KATRINA DAWN LANIER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 855-485-8273
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | 009655
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------