Healthcare Provider Details
I. General information
NPI: 1407773328
Provider Name (Legal Business Name): NILES HOMES CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
634 GEHRIG AVE
PRICHARD AL
36610-2328
US
IV. Provider business mailing address
634 GEHRIG AVE
PRICHARD AL
36610-2328
US
V. Phone/Fax
- Phone: 251-654-8635
- Fax:
- Phone: 251-654-8635
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171W00000X |
| Taxonomy | Contractor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
TERRA
VAIL
Title or Position: OWNER
Credential: CAREGIVER
Phone: 251-654-8635