Provider Demographics
NPI:1538507587
Name:PROHEALTH HOME CARE, INC
Entity Type:Organization
Organization Name:PROHEALTH HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MARLEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-300-6130
Mailing Address - Street 1:3255 W MARCH LN
Mailing Address - Street 2:SUITE 105A & 105B
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219-2304
Mailing Address - Country:US
Mailing Address - Phone:877-300-6130
Mailing Address - Fax:
Practice Address - Street 1:3255 W MARCH LN
Practice Address - Street 2:SUITE 105A & 105B
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-2304
Practice Address - Country:US
Practice Address - Phone:877-300-6130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-12
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based