NPIMap

Organization Active NPI

Secured Health and Homecare Inc

  • Nursing Care Agency
  • Brooklyn Park, MN
National Provider Identifier
1326651779
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
Legal business name
SECURED HEALTH AND HOMECARE INC
Practice address
4519 104TH Ave N
Brooklyn Park, MN 55443-1030
Phone
(763) 438-8869
NPI assigned
Aug 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Authorized official

Name
Abiola Ijadimbola
Title
Admin Director
Phone
(763) 438-8869

Specialties & licenses 10

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X
Administrator Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WA2000X
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X
Case Management Agency 251B00000X
Home Health Agency 251E00000X
Nursing Care Agency 251J00000X Primary
In Home Supportive Care Agency 253Z00000X
Assisted Living Facility 310400000X
Nursing Facility/Intermediate Care Facility 313M00000X
Secured Medical Transport (VAN) 343800000X

Addresses

Primary practice location

4519 104TH Ave N
Brooklyn Park, MN 55443-1030

Mailing address

4519 104TH Ave N
Brooklyn Park, MN 55443-1030
Phone (763) 438-8869

National Provider Directory

National Provider Directory
Tax ID family
Secured Health and Homecare Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1326651779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 104TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431030",
            "telephone_number": "763-438-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 104TH AVE N",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554431030",
            "telephone_number": "763-438-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECURED HEALTH AND HOMECARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-26",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "IJADIMBOLA",
        "authorized_official_first_name": "ABIOLA",
        "authorized_official_title_or_position": "ADMIN DIRECTOR",
        "authorized_official_telephone_number": "763-438-8869"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Administrator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343800000X",
            "taxonomy_group": "",
            "desc": "Secured Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; 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.