Evergreen Presbyterian Ministries, Inc.
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Vinton, LA
NPI 1013260488 · NPPES record last updated Oct 22, 2012
Key facts
- NPI
- 1013260488
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- License
- 2203781160 (LA)
- Legal business name
- EVERGREEN PRESBYTERIAN MINISTRIES, INC.
- Practice address
- 1805 Penny Dr
Vinton, LA 70668-4905 - Phone
- (318) 949-5500
- Fax
- (318) 949-5555
- NPI assigned
- Oct 22, 2012
- Organization subpart
- No
Authorized official
- Name
- Mr. Merlon K Craft
- Title
- Cfo
- Phone
- (318) 949-5500
Corporate family (same tax ID) 13
National Provider Directory
- Tax ID family
- Evergreen Ok Ther Leave Vocational Support
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | 2203781160 | LA | Yes |
Addresses
Primary practice location
1805 Penny Dr
Vinton, LA 70668-4905
Mailing address
2101 Highway 80
Haughton, LA 71037-9488
Phone (318) 949-5500
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2203781160 | Medicaid | LA |
Other providers in Vinton, LA
- Calcasieu Multi Handicapped Center
- Calcasieu Multi-Handicapped
- Calcasieu Multi-Handicapped Center, LLC
- Calcasieu Multi-Handicapped Center, LLC
- Calcasieu Multi-Handicapped Center, LLC
- Evergreen Presbyterian Ministries, Inc.
- Evergreen Presbyterian Ministries, Inc.
- Evergreen Presbyterian Ministries, Inc.
- Evergreen Presbyterian Ministries, Inc.
- Evergreen Presbyterian Ministries, Inc.
All providers in Vinton, LA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.