Provider Demographics
NPI:1346835766
Name:PACIFICA HOME HEALTH, INC.
Entity Type:Organization
Organization Name:PACIFICA HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GAGIK
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-340-2818
Mailing Address - Street 1:4605 LANKERSHIM BLVD STE 609
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91602-1818
Mailing Address - Country:US
Mailing Address - Phone:800-340-2818
Mailing Address - Fax:
Practice Address - Street 1:4605 LANKERSHIM BLVD STE 609
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91602-1818
Practice Address - Country:US
Practice Address - Phone:800-340-2818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NOUEAVU SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-08
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health