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General NPI Number Information
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NPI Number | 1578864377
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Entity Type | Organization
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Legal Business Name | ATHENA HOSPICE SERVICES OF MASSACHUSETTS, LLC
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Dates
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Enumeration Date | 11/10/2010
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Last Update Date | 07/31/2019
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Provider Practice Location Address
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Address Line | 10 RIVERSIDE DR STE 201
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City | LAKEVILLE
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State | MA
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Zip | 02347-1689
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Country | US
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Telephone | 508-291-0049
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Fax |
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Provider Business Mailing Address
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Address Line | 10 RIVERSIDE DR STE 201
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City | LAKEVILLE
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State | MA
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Zip | 02347-1689
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Country | US
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Telephone | 508-291-0049
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Fax | 508-291-6004
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Authorized Official
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Title or Position | MANAGER
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Name | MR. LAWRENCE G. SANTILLI
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Credential |
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Telephone | 860-751-3900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 7J03
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License Number State | MA
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