MEDICARE: SECURE HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency	012495	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	012495	OTHER	TX	TEXAS HEALTH AND HUMAN SERVICES

General Provider Information

NPI Number	:	1013145655
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SECURE HOME CARE LLC

Provider Business Mailing Address
First Line	:	1517 HEDGEWOOD TRL
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76112-4457
Country	:	US
Telephone Number	:	469-362-5290
Fax Number	:	469-362-5593

Provider Business Practice Location Address
First Line	:	1517 HEDGEWOOD TRL
Second Line	:
City	:	FT WORTH
State	:	TX
Zip	:	76112-4457
Country	:	US
Telephone Number	:	469-362-5290
Fax Number	:	469-362-5593

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL PERRY
Credential	:
Telephone Number	:	469-362-5290

Provider Enumeration Date	:	06/22/2009
Last Update Date	:	05/24/2024

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Directions to “SECURE HOME CARE LLC ” Practice Location

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