Provider Demographics
NPI:1114357118
Name:ATHENA HOME HEALTH, INC.
Entity Type:Organization
Organization Name:ATHENA HOME HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PEEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:MSN
Authorized Official - Phone:309-826-2761
Mailing Address - Street 1:112 PRANCER DR
Mailing Address - Street 2:
Mailing Address - City:HEYWORTH
Mailing Address - State:IL
Mailing Address - Zip Code:61745-9648
Mailing Address - Country:US
Mailing Address - Phone:309-826-2761
Mailing Address - Fax:
Practice Address - Street 1:112 PRANCER DR
Practice Address - Street 2:
Practice Address - City:HEYWORTH
Practice Address - State:IL
Practice Address - Zip Code:61745-9648
Practice Address - Country:US
Practice Address - Phone:309-826-2761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041378159251E00000X, 251F00000X, 251G00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care