Medical Care Management, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

2065 Issued in ME

Legal business name

MEDICAL CARE MANAGEMENT, INC

Doing business as

Russell Park Manor

Practice address

179 Lisbon St
2ND Floor
Lewiston, ME 04240-7248

Phone

(207) 786-3554

Fax

(207) 786-8507

NPI assigned

Dec 11, 2006

Last updated

Aug 22, 2020By 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

Mr. Glen G Cyr

Title

VP of Finance

Phone

(207) 786-3554

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Russell Park Manor Doing business as

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1962562272. Details of each certification follow.

• CCN 205052 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 205052

Legal name

MEDICAL CARE MANAGEMENT, INC

Doing business as

RUSSELLL PARK REHAB AND LIVING CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 19, 1981

Last certification

Mar 14, 2024

Beds

50

Ownership / control type

Corporation

Multi-facility organization

North Country Assoiciates

Organization structure

CorporationProprietary

Incorporated

Dec 30, 2000 in ME

Enrollment address

158 Russell St
Lewiston, ME 04240-6027

Nursing home name

RUSSELL PARK REHABILITATION & LIVING CENTER

Affiliated entity

NORTH COUNTRY ASSOCIATES

Listed as

Russell Park Rehabilitation & Living CenterCCN 205052 · All quality measures

Overall star rating

1 of 5

Health inspections

1 of 5

Staffing

4 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Aug 19, 1981

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

5042.9 residents per day on average

Chain

North Country Associates9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Practitioners 4

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.

• Deana L Albert, N.P.

  • Adult Health Nurse Practitioner
  • Lewiston, ME
  • NPI 1578543278
  NPD (past)
• Thomas C Hattan, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Lewiston, ME
  • NPI 1598708315
  NPD (past)
• Tina Louise Love, FNP-C

  • Family Nurse Practitioner
  • Augusta, ME
  • NPI 1275197642
  NPD (past)
• Kimberly Reenee Baker, COTA/L

  • Occupational Therapy Assistant
  • Lansing, MI
  • NPI 1700115193
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Deana L Albert, N.P.

  • Adult Health Nurse Practitioner
  • Lewiston, ME
  • NPI 1578543278

  Nursing home

  Care Compare affiliation
• Thomas C Hattan, MD

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

  Nursing home

  Care Compare affiliation
• Tina Louise Love, FNP-C

  • Family Nurse Practitioner
  • Augusta, ME
  • NPI 1275197642

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962562272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "158 RUSSELL ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406027",
            "telephone_number": "207-786-0691",
            "fax_number": "207-786-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 LISBON ST",
            "address_2": "2ND FLOOR",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407248",
            "telephone_number": "207-786-3554",
            "fax_number": "207-786-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CARE MANAGEMENT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CYR",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "207-786-3554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ME",
            "license": "2065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "024138",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russell Park Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kemedy McQuillen, MD
• Michael McRae
• Jean McWilliams
• Danielle Meader, PA-C
• Medcare LLC
• Medical Rehabilitation Associates
• Nia Megquier, DC FIAMA
• Stephanie Mellen, FNP
• James Melloh
• Sarah A Meltzer, LSWC

• Skilled Nursing Facility in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Skilled Nursing Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.