Promesa Home Care. Inc

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

5500001804 Issued in CA

Legal business name

PROMESA HOME CARE. INC

Practice address

4053 Chestnut St
Riverside, CA 92501-3536

Phone

(951) 682-3820

Fax

(866) 230-6642

NPI assigned

Jun 19, 2009

Organization subpart

No

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

Authorized official

Name

Omar Gomez, RN

Title

Don/Administrator

Phone

(951) 682-3820

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1639306301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3978 BROCKTON AVE",
            "address_2": "BUILDING B",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013203",
            "telephone_number": "951-682-3820",
            "fax_number": "866-230-6642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4053 CHESTNUT ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013536",
            "telephone_number": "951-682-3820",
            "fax_number": "866-230-6642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROMESA HOME CARE. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-19",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "OMAR",
        "authorized_official_title_or_position": "DON/ADMINISTRATOR",
        "authorized_official_telephone_number": "951-682-3820",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "CA",
            "license": "5500001804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "550001804",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in Riverside, CA
• Providers in Riverside, CA by specialty
• Nursing Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.