DLTC HEALTHCARE LLC (NPI# 1346605896) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346605896 |
| Entity Type | Organization |
| Organization Name | DLTC HEALTHCARE LLC |
| Other Organization Name | HALLDALE MANOR |
| Practice Address |
647 Maine Ave Farmingdale ME 04344-1526 |
| Mailing Address |
18 Talbot Ave Rockland ME 04841-2959 |
| Practice Telephone | 2076227082 |
| Mailing Telephone | 2075944990 |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2015-12-29 |
| Authorized Official Name | CHAD CLOUTIER (MANAGING MEMBER) |
| Authorized Official Telephone | 2075944990 |
| Is Organization Subpart | Y |
| Parent Organization Name | DAVIS LONG TERM CARE GROUP INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Halldale Manor | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437514981 | Dltc Healthcare LLC | Assisted Living Facility | 462 Essex St, Dover Foxcroft, ME 04426-1311 | 2015-12-29 |
| 1720443278 | Dltc Healthcare LLC | Assisted Living Facility | 313 State St, Augusta, ME 04330-7037 | 2015-12-29 |
| 1326403569 | Dltc Healthcare LLC | Assisted Living Facility | 45 West Main St, Searsport, ME 04974 | 2015-12-15 |
| Street Address |
647 MAINE AVE |
| City | FARMINGDALE |
| State | ME |
| Zip Code | 04344-1526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043287485 | Davis Long Term Care Group Inc | Assisted Living Facility | 647 Maine Ave, Farmingdale, ME 04344-1526 | 2006-03-03 |
| 1780885806 | Davis Long Term Care Group Inc | Assisted Living Facility | 647 Maine Ave, Farmingdale, ME 04344-1526 | 2007-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881637114 | Michele G Stevens | Physical Therapist | 14 2nd St, Farmingdale, ME 04344 | 2006-06-14 |
| 1588172811 | Maura Stottler | Specialist/Technologist | 687 Maine Ave, Farmingdale, ME 04344-1526 | 2018-01-22 |
| 1861859662 | Jennifer Leigh Hall | Social Worker | 227 Park St, Farmingdale, ME 04344-1527 | 2016-01-25 |
| 1629090519 | Ida M. Gammon-wilson | Massage Therapist | 690 Maine Ave, Farmingdale, ME 04344-1539 | 2006-07-23 |
| 1578893905 | Diane Smith | Developmental Therapist | 15 Beech St, Farmingdale, ME 04344-1603 | 2010-01-07 |
| 1295395846 | Courtney Ross | Occupational Therapist | 15 Hasson St # 1613, Farmingdale, ME 04344-1613 | 2019-06-17 |
| 1760514954 | Lisa M Mazzola | Occupational Therapist | 15 Hasson St, Farmingdale, ME 04344-1613 | 2007-03-12 |
| 1235773730 | Emily Megan Ouellette | Occupational Therapy Assistant | 15 Hasson St, Farmingdale, ME 04344-1613 | 2019-10-29 |
| 1366906992 | Meredith Ware Cohen | Occupational Therapy Assistant | 15 Hasson St, Farmingdale, ME 04344-1613 | 2019-01-28 |
| 1477004414 | Suzanne Marie Davis | Clinic/Center | 15 Hasson St, Farmingdale, ME 04344-1613 | 2016-10-14 |
| Find all providers in zip 04344 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497020150 | Maine Avenue Corp., Inc. | Assisted Living Facility | 270 Maine Ave, Farmingdale, ME 04344-4514 | 2012-03-14 |
| 1043287485 | Davis Long Term Care Group Inc | Assisted Living Facility | 647 Maine Ave, Farmingdale, ME 04344-1526 | 2006-03-03 |
| 1780885806 | Davis Long Term Care Group Inc | Assisted Living Facility | 647 Maine Ave, Farmingdale, ME 04344-1526 | 2007-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477170843 | 3m Care LLC | Assisted Living Facility | 155 Presidential Way, Westbrook, ME 04092-2553 | 2020-07-01 |
| 1053948372 | Elm Enterprises | Assisted Living Facility | 169 Veazie St, Old Town, ME 04468-1440 | 2020-03-25 |
| 1134766009 | Legrand Amisi | Assisted Living Facility | 15 Ridge Rd, Westbrook, ME 04092-2521 | 2019-12-10 |
| 1497397368 | Sunrise Adult Family Home Care | Assisted Living Facility | 11 Ocean St, Jonesport, ME 04649-3376 | 2019-10-12 |
| 1508407016 | Blandina Chitalah | Assisted Living Facility | 342 Woodford St Unit 1, Portland, ME 04103-5608 | 2019-10-05 |
| 1962058024 | Bright Lantern Home Care | Assisted Living Facility | 14 Powsland St Apt 2, Portland, ME 04102-2622 | 2019-08-14 |
| 1417514829 | Atlantic Shores | Assisted Living Facility | 100 Marshville Rd, Harrington, ME 04643-3121 | 2019-05-21 |
| 1689133142 | Catch-wim LLC | Assisted Living Facility | 434 Roosevelt Trl, Casco, ME 04015-3515 | 2019-03-14 |
| 1750873592 | Southern Harbor Eldercare Services | Assisted Living Facility | 12 Pulpit Harbor Road, North Haven, ME 04853 | 2018-06-06 |
| 1235628934 | Woodlands Senior Living of Farmington, LLC | Assisted Living Facility | 175 Knowlton Corner Rd, Farmington, ME 04938-6200 | 2018-05-08 |
| Find all providers with the same taxonomy | ||||
| City | FARMINGDALE |
| Zip Code | 04344 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.