Provider Demographics
NPI:1073275707
Name:ATHENA HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:ATHENA HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-203-7514
Mailing Address - Street 1:2408 S CARLISLE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4422
Mailing Address - Country:US
Mailing Address - Phone:610-203-7514
Mailing Address - Fax:
Practice Address - Street 1:2408 S CARLISLE ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4422
Practice Address - Country:US
Practice Address - Phone:610-203-7514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care