NPIMap

Organization Active NPI

Athena Home Health LLC

Doing business as Athena Home Health & Hospice

  • Community Based Hospice Care Agency
  • Farmington, CT
National Provider Identifier
1063810992
Registry record updated Jul 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
ATHENA HOME HEALTH LLC
Doing business as
Athena Home Health & Hospice
Practice address
135 South Rd
Farmington, CT 06032-2556
Phone
(860) 751-3620
Fax
(860) 470-7972
NPI assigned
Dec 9, 2014
Last updated
Jul 31, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
ATHENA HEATH CARE ASSOCIATES INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lawrence G. Santilli
Title
Manager
Phone
(860) 751-3900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X CT Primary

Addresses

Primary practice location

135 South Rd
Farmington, CT 06032-2556

Mailing address

135 South Rd
Farmington, CT 06032-2556
Phone (860) 751-3620

Other identifiers 2

IdentifierTypeStateIssuer
008058655MedicaidCT
05485016MedicaidNY

Other names 1

  • Athena Home Health & Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150218000974 CT Part A Provider - Hospice 4284872607 Practice locations: Farmington, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063810992. Details of each certification follow.

Hospice certification: CCN 071543

Legal name
ATHENA HOME HEALTH LLC
Doing business as
ATHENA HOME HEALTH & HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Oct 9, 2015
Last certification
Oct 9, 2015
Ownership / control type
Other
Organization structure
LLCProprietary
Incorporated
Jan 5, 2012 in CT
Enrollment address
135 South Rd
Ste 1
Farmington, CT 06032-2570

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospice

Medicare Care Compare
Listed as
Athena Home Health & HospiceCCN 071543 · All quality measures
Ownership
For-Profit
Certified
Oct 9, 2015
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Athena Care at Home3 organizations share this tax ID, including this one
Part of
Athena Health Care Associates Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

123 Quinnipiac Ave
North Haven, CT 06473
Phone (203) 303-5250

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Priscilla Senra Individual 5% Or Greater Direct Ownership Interest Dec 15, 2020 5%
Angela Massicotte Individual OtherCash Management Aug 1, 2018 1%
Lawrence E Santilli Individual 5% Or Greater Direct Ownership InterestMember Dec 15, 2020 7.5%
Marybeth Hauser Individual Corporate DirectorDirector of Payroll Oct 9, 2020 2%
Michael E Mosier Individual 5% Or Greater Direct Ownership InterestCfo Oct 9, 2020 7%
W-2 Managing EmployeeCfo Oct 9, 2020 7%
Athena Health Care Associates, Inc. Organization, Farmington, CT Corporation, Management services company Operational/Managerial Control Sep 6, 2013
Danielle Kaufman Individual Corporate DirectorDirector of Finance Jul 1, 2018 2%
Lorrie Rezendes Individual 5% Or Greater Direct Ownership Interest May 1, 2013 9%
Lawrence G Santilli Individual 5% Or Greater Direct Ownership InterestManager Dec 15, 2020 59.5%
Diane Curtis Individual Corporate DirectorDirector of Financial Operations May 1, 2013 4%
Christine Ward Individual OtherFinancial Assistant Oct 9, 2020 3%

Facilities with the same owner 25

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 25

Practitioners & affiliated clinicians

Affiliated clinicians 16

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564531200000",
    "number": "1063810992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SOUTH RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322556",
            "telephone_number": "860-751-3620",
            "fax_number": "860-470-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SOUTH RD",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322556",
            "telephone_number": "860-751-3620",
            "fax_number": "860-470-7972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA HOME HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATHENA HEATH CARE ASSOCIATES INC",
        "enumeration_date": "2014-12-09",
        "last_updated": "2019-07-31",
        "status": "A",
        "authorized_official_last_name": "SANTILLI",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "860-751-3900"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008058655",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05485016",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athena Home Health & Hospice",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Athena Home Health & Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.