Provider Demographics
NPI:1760016372
Name:SECURE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:SECURE HOME HEALTH CARE LLC
Other - Org Name:INFINITY HOME CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:228-233-8927
Mailing Address - Street 1:604 LIZ CIR
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-3712
Mailing Address - Country:US
Mailing Address - Phone:228-233-8927
Mailing Address - Fax:
Practice Address - Street 1:604 LIZ CIR
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3712
Practice Address - Country:US
Practice Address - Phone:228-233-8927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care