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PREMIO HEALTHCARE LLC NPI 1043972185


NPI Information

NPI: 1043972185
Provider Name: PREMIO HEALTHCARE LLC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
12906 BRANT ROCK DR APT 20
HOUSTON, TX
ZIP 77082
Phone: (408) 674-8679
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PREMIO HEALTHCARE LLC is an adult care home custodial care facility in Houston, TX. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. PREMIO HEALTHCARE LLC NPI is 1043972185. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

12906 BRANT ROCK DR APT 20
HOUSTON, TX
ZIP 77082-466
Phone: (408) 674-8679

The provider's authorized official is Michael Akinola Popoola .
The authorized official title is Director and has the following contact phone number (408) 674-8679.

The enumeration date for this NPI number is 10/6/2021 and was last updated on 10/6/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1171M00000XCase Manager/Care CoordinatorNo
2311ZA0620XCustodial Care FacilityAdult Care HomeYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1001MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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