Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Premium Legacy Healthcare Inc

Organization Addiction (Substance Use Disorder) Counselor · NPI 1184327249

Premium Legacy Healthcare Inc is an Addiction (Substance Use Disorder) Counselor in Phoenix, Arizona. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5062 N 19th Ave Ste 102
Phoenix, AZ 85015-3225
Phone: (773) 319-6420
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Clinic/Center (Including Community Mental Health Center) (primary) Taxonomy 261QM0801X
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X

Record details

NPI number1184327249
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ona Ekhomu — Ceo · (773) 319-6420
NPI enumeratedMarch 27, 2023
Last updated in NPPESJuly 9, 2025
Certification dateJuly 9, 2025
Mailing address11234 N 129th Way, Scottsdale, AZ 85259-4403

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