NPIMap

Organization Active NPI

Davis Long Term Care Group Inc

Doing business as The Lamp Memory Care Center

  • Alzheimer Center (Dementia Center)
  • Lisbon, ME
National Provider Identifier
1669871406
Registry record updated Sep 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
Legal business name
DAVIS LONG TERM CARE GROUP INC
Doing business as
The Lamp Memory Care Center
Practice address
64 Lisbon St
Lisbon, ME 04250-6017
Phone
(207) 353-4318
NPI assigned
Aug 18, 2014
Last updated
Sep 27, 2017By the provider in NPPES
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 Cloutier
Title
President
Phone
(207) 594-4990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X NU Primary

Addresses

Primary practice location

64 Lisbon St
Lisbon, ME 04250-6017

Mailing address

18 Talbot Ave
Rockland, ME 04841-2862

Other identifiers 1

IdentifierTypeStateIssuer
METPID005598MedicaidME

Other names 1

  • The Lamp Memory Care Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0089040Lamp Memory Care Center, the64 Lisbon Rd, Lisbon, ME 04250Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Davis Long Term Care Group 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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506470400000",
    "number": "1669871406",
    "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"
        },
        {
            "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": "DAVIS LONG TERM CARE GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-18",
        "last_updated": "2017-09-27",
        "status": "A",
        "authorized_official_last_name": "CLOUTIER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-594-4990"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "METPID005598",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Lamp Memory Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lisbon, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.