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General NPI Number Information
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NPI Number | 1265231013
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Entity Type | Organization
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Legal Business Name | PROHEALTH HOSPICE INC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 851 IRWIN ST STE 225F
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3343
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Country | US
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Telephone | 415-527-5257
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Fax | 415-480-8141
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Provider Business Mailing Address
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Address Line | 851 IRWIN ST STE 225F
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3343
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Country | US
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Telephone | 415-527-5257
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Fax | 415-480-8141
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MOHAMMED MARLEEN
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Credential |
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Telephone | 415-527-5257
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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