Provider Demographics
NPI:1710353198
Name:ATHENA HOSPICE, LLC
Entity Type:Organization
Organization Name:ATHENA HOSPICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:AHLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-850-9300
Mailing Address - Street 1:126 BARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-3580
Mailing Address - Country:US
Mailing Address - Phone:706-850-9300
Mailing Address - Fax:706-850-9303
Practice Address - Street 1:126 BARRINGTON DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-3580
Practice Address - Country:US
Practice Address - Phone:706-850-9300
Practice Address - Fax:706-850-9303
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATHENA HEALTHCARE SOLUTIONS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-19
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA15067361251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based