Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
PREMIUM LEGACY HEALTHCARE INC
Active
Organization
PREMIUM LEGACY HEALTHCARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ONA EKHOMU MBA (CEO)
(773) 319-6420
Entity
Organization
Contact information
Practice address
5062 N 19TH AVE STE 102, PHOENIX, AZ 85015-3225
(773) 319-6420
Mailing address
11234 N 129TH WAY, SCOTTSDALE, AZ 85259-4403
(773) 319-6420
(480) 462-5090
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/27/2023
Last updated
07/09/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up