Provider Demographics
NPI:1700301124
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:
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:
Authorized Official - Last Name:MARLEEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-667-8770
Mailing Address - Street 1:2700 ZANKER RD STE 180
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-2140
Mailing Address - Country:US
Mailing Address - Phone:408-451-9055
Mailing Address - Fax:
Practice Address - Street 1:1450 NEOTOMAS AVE STE 130A
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-7575
Practice Address - Country:US
Practice Address - Phone:877-667-8770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2017-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health