NPIMap

Organization Active NPI

Athena Meadowbrook, LLC

Doing business as Meadowbrook of Granby

  • Skilled Nursing Facility
  • Granby, CT
National Provider Identifier
1770547473
Registry record updated Feb 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2080C Issued in CT
Legal business name
ATHENA MEADOWBROOK, LLC
Doing business as
Meadowbrook of Granby
Practice address
350 Salmon Brook St
Granby, CT 06035-1842
Phone
(860) 653-9888
Fax
(860) 653-8938
NPI assigned
Apr 12, 2006
Last updated
Feb 15, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ATHENA HEALTH CARE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 15, 2023

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
Skilled Nursing Facility 314000000X 2080C CT Primary

Addresses

Primary practice location

350 Salmon Brook St
Granby, CT 06035-1842

Mailing address

350 Salmon Brook St
Granby, CT 06035-1842
Phone (860) 653-9888

Other names 1

  • Meadowbrook of Granby Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130107000044 CT Part A Provider - Skilled Nursing Facility 7416100193 Practice locations: Granby, CT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1770547473. Details of each certification follow.

Skilled nursing facility certification: CCN 075367

Legal name
ATHENA MEADOWBROOK LLC
Doing business as
MEADOWBROOK OF GRANBY
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 20, 1991
Last certification
Jan 23, 2024
Beds
90
Ownership / control type
Corporation
Multi-facility organization
Athena Healthcare System
Organization structure
LLCProprietary
Incorporated
Jun 7, 2012 in CT
Enrollment address
350 Salmon Brook St
Granby, CT 06035-1842
Nursing home name
CIVITA CARE MEADOWBROOK
Affiliated entity
ATHENA HEALTHCARE SYSTEMS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Civita Care MeadowbrookCCN 075367 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Nov 20, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9083.1 residents per day on average
Chain
Athena Healthcare Systems22 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Athena Meadowbrook LLC3 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.

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Lawrence E Santilli Individual 5% Or Greater Direct Ownership Interest Jun 7, 2012 9%
Michael E Mosier Individual 5% Or Greater Direct Ownership Interest Jun 7, 2012 7.33%
W-2 Managing EmployeeDelegated Official Jun 6, 1990
Athena Health Care Associates, Inc. Organization, Farmington, CT Management services company Operational/Managerial Control Jan 1, 2012
Valerie Chakalos-Santilli Individual 5% Or Greater Direct Ownership Interest Jun 7, 2012 6%
Lawrence G Santilli Individual 5% Or Greater Direct Ownership Interest Dec 31, 2018 72.67%
Diane Curtis Individual 5% Or Greater Direct Ownership Interest Jun 7, 2012 5%

Facilities with the same owner 25

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

View all 25

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.

Practitioners & affiliated clinicians

Affiliated clinicians 4

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

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1770547473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SALMON BROOK ST",
            "city": "GRANBY",
            "state": "CT",
            "postal_code": "060351842",
            "telephone_number": "860-653-9888",
            "fax_number": "860-653-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SALMON BROOK ST",
            "city": "GRANBY",
            "state": "CT",
            "postal_code": "060351842",
            "telephone_number": "860-653-9888",
            "fax_number": "860-653-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENA MEADOWBROOK, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ATHENA HEALTH CARE ASSOCIATES",
        "enumeration_date": "2006-04-12",
        "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": "2080C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meadowbrook of Granby",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meadowbrook of Granby",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granby, CT

Sources for this page

Verify at the official NPI Registry.