Organization Active NPI

Premium Nation Enterprise LLC

  • Developmentally Disabled Services Day Training Agency
  • Cypress, TX
National Provider Identifier
1619854346
Registry record updated Aug 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
PREMIUM NATION ENTERPRISE LLC
Practice address
20226 Chula Vista Dr
Cypress, TX 77433-8352
Phone
(281) 905-4487
NPI assigned
Aug 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2025

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

Authorized official

Name
Chelkie Douglas
Title
Owner
Phone
(281) 905-4487

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary
Community/Behavioral Health Agency 251S00000X
In Home Supportive Care Agency 253Z00000X
Adult Day Care Clinic/Center 261QA0600X
Developmental Disabilities Clinic/Center 261QD1600X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Assisted Living Facility (Behavioral Disturbances) 3104A0630X
Intellectual Disabilities Intermediate Care Facility 315P00000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Mental Illness Community Based Residential Treatment Facility 320800000X

Addresses

Primary practice location

20226 Chula Vista Dr
Cypress, TX 77433-8352

Mailing address

20226 Chula Vista Dr
Cypress, TX 77433-8352
Phone (281) 905-4487

Other names 1

  • Premium Healthcare Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1755216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755302400000",
    "number": "1619854346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20226 CHULA VISTA DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774338352",
            "telephone_number": "281-905-4487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20226 CHULA VISTA DR",
            "city": "CYPRESS",
            "state": "TX",
            "postal_code": "774338352",
            "telephone_number": "281-905-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM NATION ENTERPRISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-15",
        "last_updated": "2025-08-16",
        "certification_date": "2025-08-16",
        "status": "A",
        "authorized_official_last_name": "DOUGLAS",
        "authorized_official_first_name": "CHELKIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-905-4487"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premium Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Premium Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cypress, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.