Provider Demographics
NPI:1467494948
Name:SECURE HOME HEALTH MANAGEMENT, LLC
Entity type:Organization
Organization Name:SECURE HOME HEALTH MANAGEMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF GROWTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:LANIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-932-1852
Mailing Address - Street 1:8901 E F LOWRY EXPRESSWAY SUITE A
Mailing Address - Street 2:
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77591-9117
Mailing Address - Country:US
Mailing Address - Phone:409-935-7925
Mailing Address - Fax:409-935-7926
Practice Address - Street 1:1085 INTERSTATE 10 N STE B
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-4816
Practice Address - Country:US
Practice Address - Phone:409-719-0111
Practice Address - Fax:409-719-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009655251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX009655OtherTDADS HH LICENSE
TX174978001Medicaid
TX174978002Medicaid
TX009655OtherTDADS HH LICENSE