Organization
MARE ISLAND HOME HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EUNICE DOMINGO BEJAR-LEE RN (ADMINISTRATOR)
(707) 557-6800
Entity
Organization
Contact information
Practice address
1555 TENNESSEE ST, VALLEJO, CA 94590-4654
(707) 557-6800
(707) 557-6801
Mailing address
1555 TENNESSEE ST, VALLEJO, CA 94590-4654
(707) 557-6800
(707) 557-6801
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027512
BUSINESS LICENSE
CA
01
—
466916
JOINT COMMISSION
CA
01
—
550000592
CDPH STATE LICENSE
CA
Enumeration date
03/02/2007
Last updated
09/10/2014
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