# 360 HOME HEALTH AGENCY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104220623
- **Authorized official:** RAFAYEL NERSISYAN RN (PRESIDENT)
- **Authorized official phone:** (818) 888-0100

## Contact information

- **Practice address:** 21133 VICTORY BLVD, SUITE 206, CANOGA PARK, CA 91303-2829
- **Practice address phone:** (818) 888-0100
- **Mailing address:** 20741 DOLOROSA ST, WOODLAND HILLS, CA 91367-6837
- **Mailing address phone:** (818) 888-0100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | CA | Yes |

## Other

- **Enumeration date:** 10/13/2014
- **Last updated:** 12/14/2014