Organization · Type 2 NPI

Secured Health and Home Assisted Living LLC

Assisted Living Facility · Coon Rapids, MN

NPI number 1508566555 Active

Practice location

10410 Crocus St NW
Coon Rapids, MN 55433-4513

Call (763) 438-8869 Map

Fax (763) 207-1086

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	None listed
Assisted Living Facility (Mental Illness)	3104A0625X	None listed
Assisted Living Facility (Behavioral Disturbances)	3104A0630X	None listed

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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NPI record

NPI: 1508566555
Entity type: Organization (Type 2)
Issued: Mar 8, 2023
Last updated: Mar 8, 2023
Status: Active
Subpart: Yes of Secured Health and Home Care LLC

Other names

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Secured Health Assisted Living · doing business as

Authorized official

Abiola Ijadimbola, ALD
Administrative Director
(763) 438-8869

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1508566555

Secured Health and Home Assisted Living LLC's National Provider Identifier is 1508566555, issued on Mar 8, 2023. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Coon Rapids, MN. The record was last updated on Mar 8, 2023.