# ACACIA HH OF SOUTHERN CALIFORNIA, LLC

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

## Provider details

- **NPI number:** 1396900890
- **Authorized official:** MR. AVAG AGAZARYAN (PRESIDENT)
- **Authorized official phone:** (818) 241-2200

## Contact information

- **Practice address:** 1616 VICTORY BLVD, SUITE 205, GLENDALE, CA 91201-2947
- **Practice address phone:** (818) 241-2200
- **Practice address fax:** (818) 241-0671
- **Mailing address:** 1616 VICTORY BLVD, SUITE 205, GLENDALE, CA 91201-2947
- **Mailing address phone:** (818) 241-2200
- **Mailing address fax:** (818) 241-0671

## Taxonomy

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

## Other

- **Enumeration date:** 07/23/2008
- **Last updated:** 06/22/2023