Provider Demographics
NPI:1780325506
Name:ACAI HOME HEALTH CARE
Entity type:Organization
Organization Name:ACAI HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SIRANUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:AVAGYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:747-400-0132
Mailing Address - Street 1:15720 VENTURA BLVD STE 231
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2980
Mailing Address - Country:US
Mailing Address - Phone:747-400-0132
Mailing Address - Fax:747-400-0134
Practice Address - Street 1:15720 VENTURA BLVD STE 231
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2980
Practice Address - Country:US
Practice Address - Phone:747-400-0132
Practice Address - Fax:747-400-0134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health