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Organization

PREMIO HEALTHCARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL AKINOLA POPOOLA (DIRECTOR)
(408) 674-8679
Entity
Organization

Contact information

Practice address
1102 PAUL QUINN ST UNIT M, HOUSTON, TX 77091-5581
(408) 674-8679
Mailing address
1102 PAUL QUINN ST UNIT M, HOUSTON, TX 77091-5581
(408) 674-8679

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
311ZA0620X
Adult Care Home Facility
Primary
343900000X
Non-emergency Medical Transport (VAN)

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001
TX
Enumeration date
10/06/2021
Last updated
07/19/2025
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