Bristol CCH Group, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2285 Issued in CT

Legal business name

BRISTOL CCH GROUP, LLC

Doing business as

Athena Health Care Systems
Countryside Manor of Bristol

Practice address

1660 Stafford Ave
Bristol, CT 06010-2571

Phone

(860) 583-8483

Fax

(860) 585-7913

NPI assigned

Mar 23, 2006

Last updated

Feb 15, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

ATHENA HEALTH CARE ASSOCIATES INCAs reported in NPPES

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

Addresses

Other identifiers 1

Other names 2

• Athena Health Care Systems Doing business as
• Countryside Manor of Bristol Doing business as

Part of

Athena Health Care Associates Inc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Athena Health Care Associates Inc

  • Skilled Nursing Facility
  • Farmington, CT
  • NPI 1053690149
  NPPES parent name

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1073573317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1660 STAFFORD AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060102571",
            "telephone_number": "860-583-8483",
            "fax_number": "860-585-7913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 STAFFORD AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060102571",
            "telephone_number": "860-583-8483",
            "fax_number": "860-585-7913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL CCH GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATHENA HEALTH CARE ASSOCIATES INC",
        "enumeration_date": "2006-03-23",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "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": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CT",
            "license": "2285",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000021303",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athena Health Care Systems",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Countryside Manor of Bristol",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jamie Breton
• Rachel Bridgemohan, APRN
• Bridget M. McCue, LCSW, LLC
• Lauren Briggs, PHARMD, RPH
• Bristol Cardiovascular Associates, PC
• Bristol CCH Group, LLC (Countryside Manor of Bristol)
• Bristol Chiropractic & Acupuncture LLC
• Bristol Chiropractic Office LLC (SoVita Chiropractic)
• Bristol City Health Dept Dental Clinic
• Bristol Community Organization

• Skilled Nursing Facility in Bristol, CT
• Providers in Bristol, CT by specialty
• Skilled Nursing Facility in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.