MEDICARE: GOCARE HOMES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1790512127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOCARE HOMES, INC.

Provider Business Mailing Address
First Line	:	6051 SAN YSIDRO CIR
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90620-2849
Country	:	US
Telephone Number	:	510-320-4243
Fax Number	:

Provider Business Practice Location Address
First Line	:	6051 SAN YSIDRO CIR
Second Line	:
City	:	BUENA PARK
State	:	CA
Zip	:	90620-2849
Country	:	US
Telephone Number	:	510-320-4243
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. EUGENE DE MESA
Credential	:
Telephone Number	:	510-320-4243

Provider Enumeration Date	:	09/18/2024
Last Update Date	:	09/18/2024

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