Organization
PREMIUM NATION ENTERPRISE LLC
Active
Other names
Premium Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
CHELKIE DOUGLAS (OWNER)
(281) 905-4487
Entity
Organization
Contact information
Practice address
20226 CHULA VISTA DR, CYPRESS, TX 77433-8352
(281) 905-4487
Mailing address
20226 CHULA VISTA DR, CYPRESS, TX 77433-8352
(281) 905-4487
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
08/15/2025
Last updated
08/16/2025
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