Healthcare Provider Details

I. General information

NPI: 1992669006
Provider Name (Legal Business Name): RED LION HOME CARE- CONNECTICUT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2389 MAIN ST # 110
GLASTONBURY CT
06033-4617
US

IV. Provider business mailing address

2389 MAIN ST STE 110
GLASTONBURY CT
06033-4617
US

V. Phone/Fax

Practice location:
  • Phone: 215-805-1334
  • Fax:
Mailing address:
  • Phone: 215-805-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name: SCOTT RACE
Title or Position: PRESIDENT
Credential:
Phone: 215-805-1334