Healthcare Provider Details

I. General information

NPI: 1922971274
Provider Name (Legal Business Name): THREEMILE CREEK HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3262 OLD SHELL RD STE B
MOBILE AL
36607-2518
US

IV. Provider business mailing address

3262 OLD SHELL RD STE B
MOBILE AL
36607-2518
US

V. Phone/Fax

Practice location:
  • Phone: 251-380-0492
  • Fax: 251-380-0573
Mailing address:
  • Phone: 251-380-0492
  • Fax: 251-380-0573

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: MRS. AMBER TUELLER
Title or Position: SECRETARY
Credential:
Phone: 208-207-2726