Provider Demographics
NPI:1467684993
Name:ACA HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:ACA HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RIPSIME
Authorized Official - Middle Name:
Authorized Official - Last Name:PETROSYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:805-497-2773
Mailing Address - Street 1:223 E THOUSAND OAKS BLVD
Mailing Address - Street 2:SUITE 407
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5803
Mailing Address - Country:US
Mailing Address - Phone:805-497-2773
Mailing Address - Fax:805-497-3027
Practice Address - Street 1:223 E THOUSAND OAKS BLVD
Practice Address - Street 2:SUITE 407
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-5803
Practice Address - Country:US
Practice Address - Phone:805-497-2773
Practice Address - Fax:805-497-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-18
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550001446251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059341Medicare Oscar/Certification