Organization
DAVIS LONG TERM CARE GROUP INC
Active
Other names
The Lamp Memory Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD CLOUTIER (PRESIDENT)
(207) 594-4990
Entity
Organization
Contact information
Practice address
64 LISBON ST, LISBON, ME 04250-6017
(207) 353-4318
Mailing address
18 TALBOT AVE, ROCKLAND, ME 04841-2862
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
METPID005598
—
ME
Enumeration date
08/18/2014
Last updated
09/27/2017
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