Healthcare Provider Details

I. General information

NPI: 1750727582
Provider Name (Legal Business Name): HOUSE CALL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 DAUPHIN ST STE B
MOBILE AL
36604-2532
US

IV. Provider business mailing address

950 DAUPHIN ST STE B
MOBILE AL
36604-2532
US

V. Phone/Fax

Practice location:
  • Phone: 251-589-7111
  • Fax: 251-382-1936
Mailing address:
  • Phone: 251-589-7111
  • Fax: 251-382-1936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberMD29760
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberMD29760
License Number StateAL
# 5
Primary TaxonomyN
Taxonomy Code261QM1000X
TaxonomyMigrant Health Clinic/Center
License NumberMD29760
License Number StateAL
# 6
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateAL
# 8
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD29760
License Number StateAL

VIII. Authorized Official

Name: MRS. TRINA LARAY NICHOLSON
Title or Position: OFFICE MANAGER
Credential:
Phone: 251-589-7111