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General NPI Number Information
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NPI Number | 1093195646
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Entity Type | Organization
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Legal Business Name | ATHENA CARE GROUP, LLC
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Dates
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Enumeration Date | 06/08/2015
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Last Update Date | 06/08/2015
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Provider Practice Location Address
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Address Line | 32999 LAMTARRA LOOP
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City | MENIFEE
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State | CA
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Zip | 92584-7866
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Country | US
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Telephone | 562-230-3463
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Fax | 855-884-4754
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Provider Business Mailing Address
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Address Line | 32999 LAMTARRA LOOP
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City | MENIFEE
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State | CA
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Zip | 92584-7866
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Country | US
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Telephone | 562-230-3463
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Fax | 855-884-4754
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Authorized Official
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Title or Position | CO-OWNER
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Name | MS. SUSANNA FLORES
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Credential |
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Telephone | 562-230-3463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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