Active NPI
Premieant Inc
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- San Antonio, TX
National Provider Identifier
1356996896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Legal business name
- PREMIEANT INC
- Practice address
- 12427 Autumn Vista St
San Antonio, TX 78249-2407 - Phone
- (512) 916-1632
- Fax
- (512) 916-1639
- NPI assigned
- Aug 1, 2019
- Last updated
- Aug 1, 2019
- Organization subpart
- Yes
- Parent organization
- PREMIEANT INC
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Primary |
Addresses
Primary practice location
12427 Autumn Vista St
San Antonio, TX 78249-2407
Mailing address
1110 W William Cannon Dr BLDG 2
Austin, TX 78745-5468
Phone (512) 916-1632
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326141789 | Medicaid | TX | |
| 1407967573 | Medicaid | TX | |
| 1962505321 | Medicaid | TX | |
| 1144323502 | Medicaid | TX | |
| 1235232695 | Medicaid | TX | |
| 1871604934 | Medicaid | TX | |
| 1124139340 | Medicaid | TX | |
| 1235240300 | Medicaid | TX | |
| 1871696237 | Medicaid | TX | |
| 1396856514 | Medicaid | TX | |
| 1467563536 | Medicaid | TX |
National Provider Directory
National Provider Directory- Tax ID family
- Premieant Inc
- Part of
- Premieant Inc
Other organizations with this tax ID 27
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1124139340
-
- Developmentally Disabled Services Day Training Agency
- San Antonio, TX
- NPI 1295895837
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1053414417
-
dba Regency Cove
- Intellectual Disabilities Intermediate Care Facility
- San Antonio, TX
- NPI 1134760002
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1144323502
-
dba Mapletree Home
- Intellectual Disabilities Intermediate Care Facility
- San Antonio, TX
- NPI 1215588959
-
dba Forest Glade
- Intellectual Disabilities Intermediate Care Facility
- San Antonio, TX
- NPI 1225792070
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1235232695
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1235240300
-
dba Watering Trail Home
- Intellectual Disabilities Intermediate Care Facility
- San Antonio, TX
- NPI 1275290462
-
dba Watering Trail Home
- Intellectual Disabilities Intermediate Care Facility
- San Antonio, TX
- NPI 1306599121
-
- Intellectual Disabilities Intermediate Care Facility
- Austin, TX
- NPI 1326141789
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564617600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1564617600000",
"number": "1356996896",
"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": "12427 AUTUMN VISTA ST",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782492407",
"telephone_number": "512-916-1632",
"fax_number": "512-916-1639"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PREMIEANT INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PREMIEANT INC",
"enumeration_date": "2019-08-01",
"last_updated": "2019-08-01",
"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": "320900000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1326141789",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1407967573",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1962505321",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1144323502",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1235232695",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1871604934",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124139340",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1235240300",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1871696237",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1396856514",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1467563536",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}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 Aug 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.