NPIMap

Organization Active NPI

Premieant Inc

Doing business as Watering Trail Home

  • Intellectual Disabilities Intermediate Care Facility
  • San Antonio, TX
National Provider Identifier
1306599121
Registry record updated Feb 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
PREMIEANT INC
Doing business as
Watering Trail Home
Practice address
4926 Watering Trail Dr
San Antonio, TX 78247-5910
Phone
(210) 495-0302
Fax
(210) 979-8047
NPI assigned
Feb 1, 2022
Last updated
Feb 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2022

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

Authorized official

Name
Jeffrey Engelke
Title
President
Phone
(512) 916-1632

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

4926 Watering Trail Dr
San Antonio, TX 78247-5910

Mailing address

1110 W William Cannon Dr BLDG 2
Austin, TX 78745-5468
Phone (512) 916-1632

Other names 1

  • Watering Trail Home Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premiant Inc28 organizations share this tax ID, including this one

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1643673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643673600000",
    "number": "1306599121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 W WILLIAM CANNON DR BLDG 2",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787455468",
            "telephone_number": "512-916-1632",
            "fax_number": "512-916-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4926 WATERING TRAIL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782475910",
            "telephone_number": "210-495-0302",
            "fax_number": "210-979-8047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIEANT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-01",
        "last_updated": "2022-02-01",
        "certification_date": "2022-01-24",
        "status": "A",
        "authorized_official_last_name": "ENGELKE",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "512-916-1632"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Watering Trail Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2022; 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.