Provider Demographics
NPI:1588186894
Name:ATHENA CARE RESOURCES LLC
Entity type:Organization
Organization Name:ATHENA CARE RESOURCES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ABIMBOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-756-0104
Mailing Address - Street 1:14814 TULLAMORE LOOP
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5338
Mailing Address - Country:US
Mailing Address - Phone:727-637-1430
Mailing Address - Fax:
Practice Address - Street 1:1850 LEE RD STE 214
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2106
Practice Address - Country:US
Practice Address - Phone:407-756-0104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-10
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health