Premieant Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

PREMIEANT INC

Doing business as

Autumn Vista Home

Practice address

12427 Autumn Vista St
San Antonio, TX 78249-2407

Phone

(512) 916-1632

Fax

(512) 916-1639

NPI assigned

Aug 27, 2019

Organization subpart

Yes

Parent organization

PREMIEANT INCAs reported in NPPES

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

Addresses

Other identifiers 11

Other names 1

• Autumn Vista Home Doing business as

Tax ID family

Premient Inc28 organizations share this tax ID, including this one

Part of

Premient Inc

Other organizations with this tax ID 27

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

• Premiant Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Austin, TX
  • NPI 1124139340
  NPD tax ID
• Premiant Inc

  • Developmentally Disabled Services Day Training Agency
  • San Antonio, TX
  • NPI 1295895837
  NPD tax ID
• Premieant Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Austin, TX
  • NPI 1053414417
  NPD tax ID
• Premieant Inc

  dba Regency Cove

  • Intellectual Disabilities Intermediate Care Facility
  • San Antonio, TX
  • NPI 1134760002
  NPD tax ID
• Premieant Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Austin, TX
  • NPI 1144323502
  NPD tax ID
• Premieant Inc

  dba Mapletree Home

  • Intellectual Disabilities Intermediate Care Facility
  • San Antonio, TX
  • NPI 1215588959
  NPD tax ID
• Premieant Inc

  dba Forest Glade

  • Intellectual Disabilities Intermediate Care Facility
  • San Antonio, TX
  • NPI 1225792070
  NPD tax ID
• Premieant Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Austin, TX
  • NPI 1235232695
  NPD tax ID
• Premieant Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Austin, TX
  • NPI 1235240300
  NPD tax ID
• Premieant Inc

  dba Watering Trail Home

  • Intellectual Disabilities Intermediate Care Facility
  • San Antonio, TX
  • NPI 1275290462
  NPD tax ID
• Premieant Inc

  dba Watering Trail Home

  • Intellectual Disabilities Intermediate Care Facility
  • San Antonio, TX
  • NPI 1306599121
  NPD tax ID
• Premieant Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Austin, TX
  • NPI 1326141789
  NPD tax ID

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566864000000",
    "number": "1417505124",
    "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": "2019-08-27",
        "last_updated": "2019-08-27",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235240300",
            "state": "TX"
        },
        {
            "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": "1124139340",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144323502",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467563536",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871604934",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962505321",
            "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": "1235232695",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Vista Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Premieant Inc (Forest Glade)
• Premieant Inc (Watering Trail Home)
• Premieant Inc (Watering Trail Home)
• Premieant Inc
• Premieant Inc
• Premieant Inc (Tanglewood Home)
• Premier Allergy of Texas, PLLC
• Premier Dental-San Antonio, PLLC
• Premier Doppler Imaging
• Premier Hand & Upper Extremity Rehabilitation, P.C.

• Intellectual Disabilities Intermediate Care Facility in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Intellectual Disabilities Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.

Verify at the official NPI Registry.