Evergreen Cooper Lane Community Home
Intermediate care facility for individuals with intellectual disabilities in Texarkana, TX, Medicare certification number 45G359.
Medicare certification
Provider of Services- CCN
- 45G359
- Status
- Active
- Provider type
- Intermediate care facility for individuals with intellectual disabilities
- Control type
- Private (non-profit)
- Participating since
- Nov 21, 1989
- Last certification
- Aug 22, 2025
- Beds
- 6
- Address
- 3312 Cooper LN
Texarkana, TX 75503
(903) 831-4632
NPI records for this facility (CCN to NPI Mapping) 1
-
dba Evergreen Cooper Lane Community Home
- Intellectual Disabilities Intermediate Care Facility
- Texarkana, TX
- NPI 1063558138
Name & address match
Sources for this page
- Provider of Services: the certification, provider type, beds and status.
- Medicare Care Compare: the star rating and every measure on this page, with the state and national rates CMS publishes beside them.
- NPPES NPI Registry: the NPI records connected to this certification.