Plymouth Ma SNF, LLC

Primary specialty

Pediatric Skilled Nursing FacilityTaxonomy code 3140N1450X

License

0734 Issued in MA

Legal business name

PLYMOUTH MA SNF, LLC

Practice address

123 South St
Plymouth, MA 02360-2945

Phone

(508) 746-4343

Fax

(508) 746-8240

NPI assigned

Jul 10, 2014

Organization subpart

Yes

Parent organization

ATHENA HEALTH CARE ASSOCIATESAs 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

Managing Member

Phone

(860) 751-3900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Plymouth Rehab & Health Care Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Skilled nursing facility certification: CCN 225207

Legal name

PLYMOUTH MA SNF LLC

Doing business as

PLYMOUTH REHABILITATION & HEALTH CARE CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jan 28, 1972

Last certification

Dec 26, 2024

Beds

186

Ownership / control type

Corporation

Multi-facility organization

Athena Health Care Systems

Organization structure

LLCProprietary

Incorporated

Sep 1, 2012 in MA

Enrollment address

123 South St
Plymouth, MA 02360-2945

Nursing home name

PLYMOUTH REHABILITATION & HEALTH CARE CENTER

Affiliated entity

ATHENA HEALTHCARE SYSTEMS

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Plymouth Ma SNF LLC

  • Skilled Nursing Facility
  • Plymouth, MA
  • NPI 1548250079

  O20120925000641

  Same enrollment

Listed as

Plymouth Rehabilitation & Health Care CenterCCN 225207

Overall star rating

2 of 5

Health inspections

2 of 5

Staffing

2 of 5

Quality measures

2 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Jan 28, 1972

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

186141.2 residents per day on average

Chain

Athena Healthcare Systems22 facilities in the chain

Penalties (3 years)

1Fines totaling $141,373

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Plymouth Ma SNF LLC2 organizations share this tax ID, including this one

Part of

Athena Health Care Associates Inc

Other organizations with this tax ID 1

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

• Plymouth Ma SNF LLC

  • Skilled Nursing Facility
  • Plymouth, MA
  • NPI 1548250079
  NPD tax ID

Locations

All disclosed owners & managing parties 10

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

Affiliated clinicians 2

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

• Tharwat A Hanna, MD

  • Internal Medicine Physician
  • Marshfield, MA
  • NPI 1205815768

  Nursing home

  Care Compare affiliation
• Hannah Liebman, D.O.

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1366975401

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676505600000",
    "number": "1366858201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SOUTH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602945",
            "telephone_number": "508-746-4343",
            "fax_number": "508-746-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SOUTH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602945",
            "telephone_number": "508-746-4343",
            "fax_number": "508-746-8240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH MA SNF, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATHENA HEALTH CARE ASSOCIATES",
        "enumeration_date": "2014-07-10",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "SANTILLI",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "860-751-3900"
    },
    "taxonomies": [
        {
            "code": "3140N1450X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
            "state": "MA",
            "license": "0734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110094527D",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plymouth Rehab & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Plymouth Rehab & Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Plymouth Family Optometry LLC
• Plymouth Laser Center, P.C.
• Plymouth Ma SNF LLC
• Plymouth Ma SNF LLC
• Plymouth Ma SNF LLC
• Plymouth Medical Investors, LLC
• Plymouth OB-GYN Associates Inc
• Plymouth Orthodontics
• Plymouth Pathology Associates, PC
• Plymouth Pediatric Associates, LLC

• Pediatric Skilled Nursing Facility in Plymouth, MA
• Providers in Plymouth, MA by specialty
• Pediatric Skilled Nursing Facility in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.