Organization
PROMESA HOME CARE. INC
Active
Organization
PROMESA HOME CARE. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMAR GOMEZ RN (DON/ADMINISTRATOR)
(951) 682-3820
Entity
Organization
Contact information
Practice address
4053 CHESTNUT ST, RIVERSIDE, CA 92501-3536
(951) 682-3820
(866) 230-6642
Mailing address
3978 BROCKTON AVE, BUILDING B, RIVERSIDE, CA 92501-3203
(951) 682-3820
(866) 230-6642
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
5500001804
CA
251J00000X
Nursing Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550001804
STATE LICENSE
CA
Enumeration date
06/19/2009
Last updated
12/11/2015
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