NPIMap

Organization Active NPI

Evergreen Presbyterian Ministries, Inc.

Doing business as Elm Haven Community Home

  • Intellectual Disabilities Intermediate Care Facility
  • Haughton, LA
National Provider Identifier
1043368442
Registry record updated May 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
713 Issued in LA
Legal business name
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Doing business as
Elm Haven Community Home
Practice address
429 S Elm St
Haughton, LA 71037-9684
Phone
(318) 949-5022
NPI assigned
Jan 8, 2007
Last updated
May 27, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Douglas Ryland
Title
Regional Vice President
Phone
(318) 949-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 713 LA Primary

Addresses

Primary practice location

429 S Elm St
Haughton, LA 71037-9684

Mailing address

2101 Highway 80
Haughton, LA 71037-9488
Phone (318) 949-5500

Other names 1

  • Elm Haven Community Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043368442. Details of each certification follow.

  • CCN 19G442 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 19G442

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Elm Haven Group Home
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Feb 12, 1992
Last certification
Sep 10, 2025
Beds
8
Ownership / control type
Private (non-profit)
Facility address
429 South Elm
Haughton, LA 71037

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Presbyterian Ministries of Middle TN120 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

Locations

429 S Elm St
Haughton, LA 71037
Phone (318) 949-5022

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1043368442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 HIGHWAY 80",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710379488",
            "telephone_number": "318-949-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 S ELM ST",
            "city": "HAUGHTON",
            "state": "LA",
            "postal_code": "710379684",
            "telephone_number": "318-949-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PRESBYTERIAN MINISTRIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "RYLAND",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "REGIONAL VICE PRESIDENT",
        "authorized_official_telephone_number": "318-949-5500"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "LA",
            "license": "713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elm Haven Community Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Haughton, LA

Sources for this page

Verify at the official NPI Registry.