Provider Demographics
NPI:1891365045
Name:ACACIA HOSPICE INC
Entity Type:Organization
Organization Name:ACACIA HOSPICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GOHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:ARTEMYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-313-6588
Mailing Address - Street 1:12444 VICTORY BLVD STE 301-W2
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3199
Mailing Address - Country:US
Mailing Address - Phone:747-313-6588
Mailing Address - Fax:747-297-5410
Practice Address - Street 1:12444 VICTORY BLVD STE 301-W2
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3199
Practice Address - Country:US
Practice Address - Phone:747-313-6588
Practice Address - Fax:747-297-5410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based