Provider Demographics
NPI:1578933149
Name:PROFESSIONAL HEALTHCARE GROUP INC
Entity Type:Organization
Organization Name:PROFESSIONAL HEALTHCARE GROUP INC
Other - Org Name:PRO HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GEVORK
Authorized Official - Middle Name:GEV
Authorized Official - Last Name:YARALYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-753-8181
Mailing Address - Street 1:320 W BEDFORD AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-6078
Mailing Address - Country:US
Mailing Address - Phone:559-753-8181
Mailing Address - Fax:559-570-0117
Practice Address - Street 1:320 W BEDFORD AVE STE 205
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-6078
Practice Address - Country:US
Practice Address - Phone:559-753-8181
Practice Address - Fax:559-570-0117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-25
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health