NPIMap

Organization Active NPI

Prohealth Home Care, Inc

  • Home Health Agency
  • Sacramento, CA
National Provider Identifier
1215375175
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
PROHEALTH HOME CARE, INC
Practice address
1375 Exposition Blvd
Suite 250a & 250B
Sacramento, CA 95815-5115
Phone
(877) 267-1960
NPI assigned
Jun 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mohamed Marleen
Title
Owner
Phone
(916) 221-5701

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
Community Based Hospice Care Agency 251G00000X

Addresses

Primary practice location

1375 Exposition Blvd
Suite 250a & 250B
Sacramento, CA 95815-5115

Mailing address

1375 Exposition Blvd
Suite 250a & 250B
Sacramento, CA 95815-5115
Phone (915) 221-5701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20131014001000 CA Part A Provider - Hospice 4183715188 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Sacramento, CA
O20131227000212 CA Part A Provider - Home Health Agency 4183715188 Practice locations: Sacramento, CA

Hospice certification: CCN 921588

Legal name
PROHEALTH HOME CARE, INC
Certification status
Active
Provider type (POS)
Hospice
Participating since
Nov 8, 2016
Last certification
Oct 24, 2019
Ownership / control type
Proprietary - Individual
Organization structure
CorporationProprietary
Incorporated
Jun 1, 2007 in CA
Enrollment address
1375 Exposition Blvd 250B
Sacramento, CA 95815-5115

Home health agency certification: CCN 059764

Legal name
PROHEALTH HOME CARE, INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Nov 8, 2016
Last certification
Nov 7, 2019
Ownership / control type
Proprietary
Organization structure
CorporationProprietary
Incorporated
Jun 1, 2007 in CA
Enrollment address
1420 River Park Dr
Ste 200
Sacramento, CA 95815-4506
HHA Branch

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
Prohealth Home Care, IncCCN 059764
Overall star rating
2.5 of 5
Ownership
Proprietary
Certified
Nov 8, 2016
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Care Compare: Hospice

Medicare Care Compare
Listed as
Prohealth Home Care, Inc.CCN 921588
Ownership
For-Profit
Certified
Nov 8, 2016
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

1375 Exposition Blvd
#250A
Sacramento, CA 95815

1375 Exposition Blvd
Ste 250A
Sacramento, CA 95815
Phone (877) 267-1960

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mohamed Shahram Marleen Individual 5% Or Greater Direct Ownership InterestPresident/Ceo Jun 1, 2007 100%
Corporate OfficerPresident/Ceo Jun 1, 2007 100%
Corporate DirectorCeo Jun 1, 2007 100%
Operational/Managerial ControlPresident/Ceo Jun 1, 2007 50%
5% Or Greater Direct Ownership InterestCeo, President Jun 1, 2007 50%
Corporate OfficerCeo, President Jun 1, 2007 50%
Corporate DirectorCeo President Jun 1, 2007 50%
Operational/Managerial ControlCeo, President Jun 1, 2007 50%
Malalai Mohideen Individual 5% Or Greater Direct Ownership InterestVice President Jun 1, 2007 50%
Corporate OfficerVice President Jun 1, 2007 50%
Corporate DirectorVice President Jun 1, 2007 50%
Operational/Managerial ControlVice President Jun 1, 2007 50%

Practitioners & affiliated clinicians

Affiliated clinicians 68

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 68

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1370995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637280000000",
    "number": "1215375175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 EXPOSITION BLVD",
            "address_2": "SUITE 250A & 250B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958155115",
            "telephone_number": "915-221-5701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 EXPOSITION BLVD",
            "address_2": "SUITE 250A & 250B",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958155115",
            "telephone_number": "877-267-1960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROHEALTH HOME CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-12",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A",
        "authorized_official_last_name": "MARLEEN",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-221-5701"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.