MEDICARE: SECURED HEALTH AND HOMECARE INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	163W00000X	Registered Nurse
2	163WA2000X	Administrator Registered Nurse
3	163WH0200X	Home Health Registered Nurse
4	251B00000X	Case Management Agency
5	251E00000X	Home Health Agency
6	253Z00000X	In Home Supportive Care Agency
7	310400000X	Assisted Living Facility
8	313M00000X	Nursing Facility/Intermediate Care Facility
9	343800000X	Secured Medical Transport (VAN)
10	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1326651779
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SECURED HEALTH AND HOMECARE INC

Provider Business Mailing Address
First Line	:	4519 104TH AVE N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55443-1030
Country	:	US
Telephone Number	:	763-438-8869
Fax Number	:

Provider Business Practice Location Address
First Line	:	4519 104TH AVE N
Second Line	:
City	:	BROOKLYN PARK
State	:	MN
Zip	:	55443-1030
Country	:	US
Telephone Number	:	763-438-8869
Fax Number	:

Authorized Official
Title or Position	:	ADMIN DIRECTOR
Name	:	ABIOLA IJADIMBOLA
Credential	:
Telephone Number	:	763-438-8869

Provider Enumeration Date	:	08/26/2020
Last Update Date	:	07/20/2021

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Directions to “SECURED HEALTH AND HOMECARE INC ” Practice Location

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