Athena Leasing, LLC

Key facts

NPI

1073706362

Entity type

Organization (NPI type 2)

Primary specialty

Skilled Nursing Facility 314000000X

License

4948 (TX)

Legal business name

ATHENA LEASING, LLC

Practice address

1621 Butler Dr
Dimmitt, TX 79027-2701

Phone

(806) 647-3117

NPI assigned

Aug 21, 2007

Organization subpart

No

Authorized official

Name

Gerry Dwain Fowler

Title

Managing Partner

Phone

(972) 355-4957

Corporate family (same tax ID) 1

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

• Athena Leasing LLC Skilled Nursing Facility · Amarillo, TX · NPI 1790839579
  NPD tax ID

National Provider Directory

Tax ID family

Athena Leasing LLC (2 organizations share this tax ID)

Locations

Specialties & licenses

Addresses

Other names

• Dimmitt Nursing Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 21, 2007.

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1073706362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 CROSS TIMBERS RD",
            "address_2": "SUITE 1060",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750281371",
            "telephone_number": "972-355-4957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1621 BUTLER DR",
            "city": "DIMMITT",
            "state": "TX",
            "postal_code": "790272701",
            "telephone_number": "806-647-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA LEASING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "GERRY",
        "authorized_official_middle_name": "DWAIN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "972-355-4957"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "4948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dimmitt Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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