Oxford Ma SNF LLC
Organization Active NPI Skilled Nursing Facility · Haverhill, MA
NPI 1154732832 · NPPES record last updated Feb 16, 2023
Key facts
- NPI
- 1154732832
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 0700 (MA)
- Legal business name
- OXFORD MA SNF LLC
- Practice address
- 689 Main St
Haverhill, MA 01830-2643 - Phone
- (978) 373-1131
- Fax
- (978) 373-3074
- NPI assigned
- May 15, 2014
- Organization subpart
- Yes
- Parent organization (as reported)
- ATHENA HEALTH CARE ASSOCIATES INC.
Authorized official
- Name
- Lawrence G. Santilli
- Title
- Manager
- Phone
- (860) 751-3900
Facilities with the same owner 25
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Skilled nursing facility certification: CCN 225218001
- Legal name
- OXFORD MA SNF LLC
- Doing business as
- THE OXFORD REHABILITATION AND HEALTH CARE CENTER
- Organization structure
- LLC · Proprietary
- Incorporated
- Oct 10, 2013 in MA
- Enrollment address
- 689 Main St
Haverhill, MA 01830-2643 - Nursing home name
- OXFORD REHABILITATION & HEALTH CARE CENTER
- Affiliated entity
- ATHENA HEALTHCARE SYSTEMS
All disclosed owners & managing parties 8
| Name | Role | Since | Share |
|---|---|---|---|
| Priscilla Senra |
5% Or Greater Indirect Ownership Interest | Dec 15, 2020 | 4% |
| Lawrence E Santilli |
5% Or Greater Indirect Ownership Interest | Jul 1, 2015 | 12% |
| Michael E Mosier |
5% Or Greater Indirect Ownership Interest | Nov 18, 2016 | 6.66% |
| W-2 Managing Employee |
Jun 1, 2014 | ||
| Athena Health Care Systems Ma III LLC |
5% Or Greater Direct Ownership Interest | Jun 1, 2014 | 100% |
| Athena Health Care Associates, Inc. |
Operational/Managerial Control | Jun 1, 2014 | |
| Valerie Chakalos-Santilli |
5% Or Greater Indirect Ownership Interest | Jul 1, 2015 | 6% |
| Lawrence G Santilli |
5% Or Greater Indirect Ownership Interest |
Oct 4, 2019 | 61.67% |
| Corporate Officer |
Oct 4, 2018 | ||
| Diane Curtis |
5% Or Greater Indirect Ownership Interest | Jun 1, 2014 | 3% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140418000420 | MA | Part a Provider - Skilled Nursing Facility | 8729210042 | Practice locations: Haverhill, MA |
National Provider Directory
- Part of
- Athena Health Care Associates Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 0700 | MA | Yes |
Addresses
Primary practice location
689 Main St
Haverhill, MA 01830-2643
Mailing address
689 Main St
Haverhill, MA 01830-2643
Phone (978) 373-1131
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110100221A | Medicaid | MA |
Other names
- The Oxford Rehabilitation and Health Care Center
Other providers in Haverhill, MA
- Orthopaedics Northeast, LLC
- Wendy R Osgood
- David Oswalt
- Lillian Otokhagua
- Joseph Ouellette
- Karen M Palazzo
- Tracy Palumbo
- Rajeev Panakanti
- Tamara Gail Panza
- Vincent Joseph Paolino
All providers in Haverhill, MA · Skilled Nursing Facility in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.