NPIMap

Organization Active NPI

Davis Long Term Care Group Inc

  • Assisted Living Facility
  • Athens, ME
National Provider Identifier
1457328890
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
121610000 Issued in ME
Legal business name
DAVIS LONG TERM CARE GROUP INC
Practice address
212 Fox Hill Rd
Athens, ME 04912-4719
Phone
(207) 654-2713
Fax
(207) 654-2170
NPI assigned
Mar 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Chad A Cloutier
Title
President
Phone
(207) 594-4990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 121610000 ME Primary

Addresses

Primary practice location

212 Fox Hill Rd
Athens, ME 04912-4719

Mailing address

18 Talbot Ave
Rockland, ME 04841-2862
Phone (207) 594-4990

Other identifiers 1

IdentifierTypeStateIssuer
METPID002103MedicaidME

Other names 1

  • Tissues Country Estate Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Davis Long Term Care Grop Inc23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506470400000",
    "number": "1457328890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 TALBOT AVE",
            "city": "ROCKLAND",
            "state": "ME",
            "postal_code": "048412862",
            "telephone_number": "207-594-4990",
            "fax_number": "207-594-4974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 FOX HILL RD",
            "city": "ATHENS",
            "state": "ME",
            "postal_code": "049124719",
            "telephone_number": "207-654-2713",
            "fax_number": "207-654-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVIS LONG TERM CARE GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-03",
        "last_updated": "2017-09-27",
        "status": "A",
        "authorized_official_last_name": "CLOUTIER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-594-4990"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ME",
            "license": "121610000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "METPID002103",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tissues Country Estate",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Athens, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.