Brock Lamp LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BROCK LAMP LLC

Doing business as

Lamp Memory Care Assisted Living

Practice address

64 Lisbon St
Lisbon, ME 04250-6017

Phone

(207) 353-4318

NPI assigned

Dec 2, 2024

Last updated

Dec 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly Wesbrock

Title

Chief Executive Officer

Phone

(207) 691-5059

Specialties & licenses 1

Addresses

Other names 1

• LAMP MEMORY CARE ASSISTED LIVING Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas C Hattan, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Lewiston, ME
  • NPI 1598708315
  NPD (past)

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1487470761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 LISBON ST",
            "city": "LISBON",
            "state": "ME",
            "postal_code": "042506017",
            "telephone_number": "207-353-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 LISBON ST",
            "city": "LISBON",
            "state": "ME",
            "postal_code": "042506017",
            "telephone_number": "207-353-4318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCK LAMP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A",
        "authorized_official_last_name": "WESBROCK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "207-691-5059"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAMP MEMORY CARE ASSISTED LIVING",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Starr Baxter, LCSW
• Seth Patrick Beal, MOT OTR/L
• John Joseph Bianchi, DMD
• Brock Health Inc
• Thomas P Chacko
• Theresa Collins, LCPC C
• Davis Long Term Care Group Inc (The Lamp Memory Care Center)
• Robin Elizabeth Deatrich, LMSW., CH
• Joan L Detel, RN, LMSW

• Assisted Living Facility in Lisbon, ME
• Providers in Lisbon, ME by specialty
• Assisted Living Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.