MEDICARE: REDDING LIFE CARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	2266	CT

General Provider Information

NPI Number	:	1487638144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REDDING LIFE CARE, LLC

Provider Business Mailing Address
First Line	:	100 REDDING RD
Second Line	:
City	:	REDDING
State	:	CT
Zip	:	06896-3236
Country	:	US
Telephone Number	:	203-544-1000
Fax Number	:	203-544-1200

Provider Business Practice Location Address
First Line	:	100 REDDING RD
Second Line	:
City	:	REDDING
State	:	CT
Zip	:	06896-3220
Country	:	US
Telephone Number	:	203-544-1000
Fax Number	:	203-544-1200

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. DAVID REIS
Credential	:
Telephone Number	:	203-222-6262

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	08/28/2019

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Directions to “REDDING LIFE CARE, LLC ” Practice Location

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