Premio Healthcare LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

PREMIO HEALTHCARE LLC

Practice address

1102 Paul Quinn St Unit M
Houston, TX 77091-5581

Phone

(408) 674-8679

NPI assigned

Oct 6, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael Akinola Popoola

Title

Director

Phone

(408) 674-8679

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752883200000",
    "number": "1043972185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 PAUL QUINN ST UNIT M",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770915581",
            "telephone_number": "408-674-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 PAUL QUINN ST UNIT M",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770915581",
            "telephone_number": "408-674-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIO HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-06",
        "last_updated": "2025-07-19",
        "certification_date": "2025-07-19",
        "status": "A",
        "authorized_official_last_name": "POPOOLA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "AKINOLA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "408-674-8679"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "12906BRANTROCKDRAPT20HOUSTONTEXAS77082",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "12906 Brant Rock Dr Apt 20",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770825466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://www.premiohealthcare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1102 Paul Quinn St Unit M",
            "city": "Houston",
            "state": "TX",
            "country_code": "US",
            "postal_code": "770915581",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adult Care Home Facility in Houston, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.