NPIMap

Organization Active NPI

Evergreen Presbyterian Ministries, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Vinton, LA
National Provider Identifier
1205189677
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
2203781162 Issued in LA
Legal business name
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Practice address
1710 Mill St
Vinton, LA 70668-3718
Phone
(318) 949-5500
Fax
(318) 949-5555
NPI assigned
Oct 22, 2012
Last updated
Oct 22, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Authorized official

Name
Mr. Merlon Kent Craft
Title
Cfo
Phone
(318) 949-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 2203781162 LA Primary

Addresses

Primary practice location

1710 Mill St
Vinton, LA 70668-3718

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2203781162MedicaidLA

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Ok Transportation120 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1205189677",
    "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",
            "fax_number": "318-949-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 MILL ST",
            "city": "VINTON",
            "state": "LA",
            "postal_code": "706683718",
            "telephone_number": "318-949-5500",
            "fax_number": "318-949-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PRESBYTERIAN MINISTRIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "CRAFT",
        "authorized_official_first_name": "MERLON",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "318-949-5500",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "2203781162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2203781162",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vinton, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.