Provider Demographics
NPI:1689943243
Name:PROHEALTH HOME CARE INC
Entity Type:Organization
Organization Name:PROHEALTH HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:SHAHRAM
Authorized Official - Last Name:MARLEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-451-9055
Mailing Address - Street 1:2125 OAK GROVE RD STE 124A
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2534
Mailing Address - Country:US
Mailing Address - Phone:877-258-0336
Mailing Address - Fax:408-451-9217
Practice Address - Street 1:2125 OAK GROVE RD STE 124A
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2534
Practice Address - Country:US
Practice Address - Phone:877-258-0336
Practice Address - Fax:408-451-9217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-27
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X, 251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based