Organization
DAVIS LONG TERM CARE GROUP INC
Active
Other names
Tissues Country Estate
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD A CLOUTIER (PRESIDENT)
(207) 594-4990
Entity
Organization
Contact information
Practice address
212 FOX HILL RD, ATHENS, ME 04912-4719
(207) 654-2713
(207) 654-2170
Mailing address
18 TALBOT AVE, ROCKLAND, ME 04841-2862
(207) 594-4990
(207) 594-4974
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
121610000
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
METPID002103
—
ME
Enumeration date
03/03/2006
Last updated
09/27/2017
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