Provider Demographics
NPI:1750613113
Name:SECURED HOME HEALTH SERVICES LLC
Entity type:Organization
Organization Name:SECURED HOME HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR / DIRECTOR OF NURSING
Authorized Official - Prefix:MS
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:AJUBESE
Authorized Official - Last Name:NJEM
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:703-928-4226
Mailing Address - Street 1:9401 MATHY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5310
Mailing Address - Country:US
Mailing Address - Phone:703-268-5910
Mailing Address - Fax:703-539-8350
Practice Address - Street 1:9401 MATHY DR
Practice Address - Street 2:SUITE 300
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5310
Practice Address - Country:US
Practice Address - Phone:703-268-5910
Practice Address - Fax:703-539-8350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-09
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO10630251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health