Secure Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

License

012495 Issued in TX

Legal business name

SECURE HOME CARE LLC

Practice address

1517 Hedgewood TRL
Ft Worth, TX 76112-4457

Phone

(469) 362-5290

Fax

(469) 362-5593

NPI assigned

Jun 22, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Perry

Title

Owner

Phone

(469) 362-5290

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Secure Home Care Doing business as

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716508800000",
    "number": "1013145655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1517 HEDGEWOOD TRL",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761124457",
            "telephone_number": "469-362-5290",
            "fax_number": "469-362-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1517 HEDGEWOOD TRL",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761124457",
            "telephone_number": "469-362-5290",
            "fax_number": "469-362-5593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECURE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "469-362-5290"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "TX",
            "license": "012495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS HEALTH AND HUMAN SERVICES",
            "identifier": "012495",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://410.axiscare.com",
            "affiliation": "N",
            "address_1": "1517 Hedgewood Trl",
            "city": "Ft Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761124457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Secure Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.