Provider Demographics
NPI:1104170562
Name:PREMIER ASSISTED LIVING HOMES # 2
Entity type:Organization
Organization Name:PREMIER ASSISTED LIVING HOMES # 2
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ONWUHARONYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-827-1477
Mailing Address - Street 1:9135 RENTUR DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-1125
Mailing Address - Country:US
Mailing Address - Phone:713-988-1266
Mailing Address - Fax:713-988-1660
Practice Address - Street 1:10607 RAYDELL DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-1807
Practice Address - Country:US
Practice Address - Phone:281-827-1477
Practice Address - Fax:281-530-6266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-06
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX131312310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility