Provider Demographics
NPI:1336674563
Name:SAFE AND SECURE SENIOR CARE, LLC
Entity Type:Organization
Organization Name:SAFE AND SECURE SENIOR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENNETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-771-2497
Mailing Address - Street 1:3017 DOUGLAS BLVD
Mailing Address - Street 2:300
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3848
Mailing Address - Country:US
Mailing Address - Phone:916-771-2497
Mailing Address - Fax:
Practice Address - Street 1:3017 DOUGLAS BLVD
Practice Address - Street 2:300
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3848
Practice Address - Country:US
Practice Address - Phone:916-771-2497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA314700017251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health