NA
NPI 1104170562
Assisted Living Facility in Houston, TX
NPI Status: Active since November 06, 2012
Contact Information
10607 RAYDELL DR
HOUSTON, TX
ZIP 77031
Phone: (281) 827-1477
Fax: (281) 530-6266
- Organization
- Assisted Living Facility
- CLIA Number: 45D1005120
- CLIA Cert. Type: Home Health Agency
- CLIA Exp. Date: 10-14-2026
About NA
This page provides the complete NPI Profile along with additional information for Na, a provider established in Houston, Texas operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1104170562 assigned on November 2012. The practitioner's primary taxonomy code is 310400000X with license number 131312 (TX). The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Na. The authorized official of this NPI record is Mr. Samuel Onwuharonye (Administrator)
- NPI
- 1104170562
- Provider Legal Name
- PREMIER ASSISTED LIVING HOMES # 2
- Other Organization Name
- NA
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 10607 RAYDELL DR HOUSTON, TX 77031
- Location Phone
- (281) 827-1477
- Location Fax
- (281) 530-6266
- Mailing Address
- 9135 RENTUR DR HOUSTON, TX 77031
- Mailing Phone
- (713) 988-1266
- Mailing Fax
- (281) 530-6266
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-06-2012
- Last Update Date
- 11-14-2012
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Assisted Living Facility
- Taxonomy Code
- 310400000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 131312
- License State
- TX
- Taxonomy Description
- A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D1005120
- Facility Type
- Home Health Agency
- Certificate Effective Date
- October 15, 2024
- Certificate Expiration Date
- October 14, 2026
- Laboratory Director
- BAMIDELE JOKODOLA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Na to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 0 | 4 | 1 | 7 | 0 | 5 | 6 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 0 | 4 | 2 | 7 | 0 | 5 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 0 + 4 + 2 + 7 + 0 + 5 + 1 + 2 + 24 = 48 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 48 = 2 | 2 | ||||||||
The NPI number 1104170562 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104170562, enumerated in the NPI registry as an "organization" on November 06, 2012
The provider is located at 10607 Raydell Dr Houston, Tx 77031 and the phone number is (281) 827-1477
This medical organization specializes in Assisted Living Facility with taxonomy code 310400000X
The provider's CLIA number is 45D1005120 for a "home health agency" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on November 06, 2012. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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