Provider Demographics
NPI:1730770025
Name:ATHENA RHODE ISLAND HOSPICE LLC
Entity type:Organization
Organization Name:ATHENA RHODE ISLAND HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:G
Authorized Official - Last Name:SANTILLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-751-3900
Mailing Address - Street 1:135 SOUTH RD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-2556
Mailing Address - Country:US
Mailing Address - Phone:860-751-3915
Mailing Address - Fax:
Practice Address - Street 1:300 TOLL GATE RD STE 201
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4448
Practice Address - Country:US
Practice Address - Phone:401-238-7300
Practice Address - Fax:401-238-7575
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATHENA HEALTH CARE ASSOCIATES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-29
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIAT13116Medicaid