Healthcare Provider Details

I. General information

NPI: 1033030242
Provider Name (Legal Business Name): SHADREN HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 RUELA DR
NAUGATUCK CT
06770-3308
US

IV. Provider business mailing address

164 RUELA DR
NAUGATUCK CT
06770-3308
US

V. Phone/Fax

Practice location:
  • Phone: 203-721-6130
  • Fax:
Mailing address:
  • Phone: 203-721-6130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. THOMAS DAVIES
Title or Position: OWNER
Credential:
Phone: 203-308-3165