Provider Demographics
NPI:1386764165
Name:SECURE AND SAFE AT HOME
Entity type:Organization
Organization Name:SECURE AND SAFE AT HOME
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-261-0448
Mailing Address - Street 1:423 RAVENSWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33954-1955
Mailing Address - Country:US
Mailing Address - Phone:855-277-0975
Mailing Address - Fax:888-936-0123
Practice Address - Street 1:423 RAVENSWOOD BLVD
Practice Address - Street 2:
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33954-1955
Practice Address - Country:US
Practice Address - Phone:855-277-0975
Practice Address - Fax:888-936-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0445847Medicaid