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General NPI Number Information
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NPI Number | 1255154985
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Entity Type | Organization
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Legal Business Name | THREE ROCKS HEALTHCARE LLC
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 798 SE HIGHWAY 101
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City | LINCOLN CITY
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State | OR
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Zip | 97367-2715
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Country | US
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Telephone | 541-264-7823
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Fax | 541-283-0150
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Provider Business Mailing Address
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Address Line | 798 SE HIGHWAY 101
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City | LINCOLN CITY
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State | OR
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Zip | 97367-2715
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | AMBER LYNN TUELLER
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Credential |
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Telephone | 208-207-2726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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