NPIMap

Organization Active NPI

DLTC Healthcare LLC

Doing business as Capitol City Manor

  • Assisted Living Facility
  • Augusta, ME
National Provider Identifier
1720443278
Registry record updated Dec 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
DLTC HEALTHCARE LLC
Doing business as
Capitol City Manor
Practice address
313 State St
Augusta, ME 04330-7037
Phone
(207) 622-6823
NPI assigned
Dec 29, 2015
Last updated
Dec 29, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
DAVIS LONG TERM CARE GROUP INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 29, 2015

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

Authorized official

Name
Chad Cloutier
Title
Managing Member
Phone
(207) 594-4990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

313 State St
Augusta, ME 04330-7037

Mailing address

18 Talbot Ave
Rockland, ME 04841-2959
Phone (207) 594-4990

Other names 1

  • Capitol City Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
DLTC Healthcare LLC4 organizations share this tax ID, including this one
Part of
Davis Long Term Care Group Inc

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1451347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451347200000",
    "number": "1720443278",
    "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": "048412959",
            "telephone_number": "207-594-4990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 STATE ST",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043307037",
            "telephone_number": "207-622-6823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DLTC HEALTHCARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVIS LONG TERM CARE GROUP INC",
        "enumeration_date": "2015-12-29",
        "last_updated": "2015-12-29",
        "status": "A",
        "authorized_official_last_name": "CLOUTIER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "207-594-4990"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capitol City Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2015; 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.