PREMIEANT INC (NPI# 1417505124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417505124 |
| Entity Type | Organization |
| Organization Name | PREMIEANT INC |
| Practice Address |
12427 Autumn Vista St San Antonio TX 78249-2407 |
| Mailing Address |
1110 W William Cannon Dr Bldg 2 Austin TX 78745-5468 |
| Practice Telephone | 5129161632 |
| Practice Fax Number | 5129161639 |
| Mailing Telephone | 5129161632 |
| Mailing Fax Number | 5129161639 |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-08-27 |
| Authorized Official Name | JEFFREY ENGELKE (PRESIDENT) |
| Authorized Official Telephone | 5129161632 |
| Is Organization Subpart | Y |
| Parent Organization Name | PREMIEANT INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 1235240300 | 05 | |
| TX | 1144323502 | 05 | |
| TX | 1326141789 | 05 | |
| TX | 1962505321 | 05 | |
| TX | 1396856514 | 05 | |
| TX | 1235232695 | 05 | |
| TX | 1407967573 | 05 | |
| TX | 1467563536 | 05 | |
| TX | 1871604934 | 05 | |
| TX | 1871696237 | 05 | |
| TX | 1124139340 | 05 |
| Other Name | Type Code |
|---|---|
| Autumn Vista Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134760002 | Premieant Inc | Intermediate Care Facility, Mentally Retarded | 6402 Regency Cv, San Antonio, TX 78249-4844 | 2019-10-02 |
| 1548324692 | Premieant Inc | Custodial Care Facility | 1110 West William Cannon, Building 2, Austin, TX 78745 | 2006-12-21 |
| 1790845782 | Premieant Inc | Day Training, Developmentally Disabled Services | 1110 W William Cannon, Building 2, Austin, TX 78745 | 2006-12-11 |
| 1356409213 | Premieant Inc | Custodial Care Facility | 2021 Industrial Drive, Mcallen, TX 78504 | 2006-12-04 |
| 1871696237 | Premieant Inc | Intermediate Care Facility, Mentally Retarded | 101 Cloudview, Austin, TX 78745 | 2006-09-07 |
| 1144323502 | Premieant Inc | Intermediate Care Facility, Mentally Retarded | 1203 Echo Lane, Austin, TX 78745 | 2006-09-07 |
| 1417050873 | Premieant Inc | Intermediate Care Facility, Mentally Retarded | 7303 Daugherty, Austin, TX 78758 | 2006-09-07 |
| 1326141789 | Premieant Inc | Intermediate Care Facility, Mentally Retarded | 1400 Pine Knoll Dr, Austin, TX 78758 | 2006-09-07 |
| 1235232695 | Premieant Inc | Intermediate Care Facility, Mentally Retarded | 7509 Westgate Blvd, Austin, TX 78745 | 2006-09-07 |
| 1053414417 | Premieant Inc | Intermediate Care Facility, Mentally Retarded | 6900 Whispering Oaks, Austin, TX 78745 | 2006-09-07 |
| Street Address |
12427 AUTUMN VISTA ST |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78249-2407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184053084 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 12427 Autumn Vista St, San Antonio, TX 78249-2407 | 2013-11-01 |
| 1356996896 | Premieant Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12427 Autumn Vista St, San Antonio, TX 78249-2407 | 2019-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222663 | Zachary Mitchell Kimo Mitsui | Specialist/Technologist | 7311 Bluestone Rd, San Antonio, TX 78249 | 2020-10-15 |
| 1538770839 | Go Operations 3 LLC | Skilled Nursing Facility | 4366 Lockhill Selma, Shavano, TX 78249 | 2020-08-11 |
| 1417566548 | Heenaben Jayantilal Rathod | Registered Nurse | 5803 Utsa Blvd, Apt #2101, San Antonio, TX 78249 | 2020-07-24 |
| 1306455530 | Z-pediatrics Pllc | Pediatrics | 5886 Dezavala Rd Suite 101 #510, San Antonio, TX 78249 | 2020-07-23 |
| 1568080497 | San Antonio Wisdom Teeth, Pllc | Dentist | 13535 Hausman Pass #102-a, San Antonio, TX 78249 | 2020-07-07 |
| 1265071203 | Caralyne Sandquist | Physician Assistant | 5510 Presidio Parkway, Building #2 Suite 2401, San Antonio, TX 78249 | 2019-12-21 |
| 1104472935 | Adam J Gordon | Social Worker | 6363 Dezavala Rd, San Antonio, TX 78249 | 2019-08-16 |
| 1336700582 | Michael Leland Post | Specialist/Technologist | 5150 Dezavala, San Antonio, TX 78249 | 2019-06-27 |
| 1043788722 | Stephen John Reynolds | Counselor | 5907 Trent Rnch, San Antonio, TX 78249 | 2018-11-11 |
| 1396211504 | Christina Michelle Morales | Specialist/Technologist | 4533 N Loop 1604 E, Ste 1119, San Antonio, TX 78249 | 2018-10-16 |
| Find all providers in zip 78249 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134760002 | Premieant Inc | Intermediate Care Facility, Mentally Retarded | 6402 Regency Cv, San Antonio, TX 78249-4844 | 2019-10-02 |
| 1285299636 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 6647 Cades Cv, San Antonio, TX 78238-2238 | 2019-05-01 |
| 1730744186 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 7422 Quail Run Dr, San Antonio, TX 78209-3129 | 2019-05-01 |
| 1346692712 | Anchor Habilitation Service LLC | Intermediate Care Facility, Mentally Retarded | 18843 Redland Rd, San Antonio, TX 78259-3562 | 2016-07-08 |
| 1649609132 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 5303 Vista Run Dr, San Antonio, TX 78247-4684 | 2013-11-05 |
| 1700215290 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 12342 Mapletree St, San Antonio, TX 78249-2429 | 2013-11-05 |
| 1316376924 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 14038 Boulder Oaks, San Antonio, TX 78247-3103 | 2013-11-04 |
| 1710316328 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 5119 Stormy Sunset, San Antonio, TX 78247-1721 | 2013-11-04 |
| 1639508245 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 5223 Stormy Sunset, San Antonio, TX 78247-1723 | 2013-11-04 |
| 1902235518 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 17002 Vista Briar Dr, San Antonio, TX 78247-4636 | 2013-11-04 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78249 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.