Premium Legacy Healthcare Inc
NPI 1184327249 · Mental Health Clinic/Center (Including Community Mental Health Center) · Phoenix, AZ
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Premium Legacy Healthcare Inc is a Mental Health Clinic/Center (Including Community Mental Health Center) organization in Phoenix, AZ (NPI 1184327249).
Provider details
- NPI number
- 1184327249
- Entity type
- Organization
- Primary specialty
- Mental Health Clinic/Center (Including Community Mental Health Center)Ambulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Ona Ekhomu, Ceo(773) 319-6420
Specialties & taxonomies
Ambulatory Health Care Facilities
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2023-03-27
- Last updated
- 2025-07-09
- Certified
- 2025-07-09
Frequently asked questions
- What is Premium Legacy Healthcare Inc's NPI number?
- Premium Legacy Healthcare Inc's National Provider Identifier (NPI) is 1184327249, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Premium Legacy Healthcare Inc?
- Premium Legacy Healthcare Inc is classified in the NPPES registry as Mental Health Clinic/Center (Including Community Mental Health Center) (Ambulatory Health Care Facilities).
- Where is Premium Legacy Healthcare Inc located?
- Premium Legacy Healthcare Inc's practice location on file with NPPES is 5062 N 19th Ave Ste 102, Phoenix, AZ 85015-3225.
- What is Premium Legacy Healthcare Inc's phone number?
- The practice phone number listed in the NPPES registry for Premium Legacy Healthcare Inc is (773) 319-6420.
- Does Premium Legacy Healthcare Inc accept Medicare?
- Premium Legacy Healthcare Inc is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Premium Legacy Healthcare Inc?
- The authorized official listed on Premium Legacy Healthcare Inc's NPPES record is Ona Ekhomu, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Premium Legacy Healthcare Inc's NPI active?
- Yes — Premium Legacy Healthcare Inc's NPI (1184327249) is active in the NPPES registry as of the last update on 2025-07-09.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.