NPIMap

Organization Active NPI

Evergreen Ok Daily Living Support

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Oklahoma City, OK
National Provider Identifier
1467570051
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
EVERGREEN OK DAILY LIVING SUPPORT
Practice address
7725 W Britton Rd
Oklahoma City, OK 73132-1507
Phone
(405) 720-1192
Fax
(405) 720-1193
NPI assigned
Mar 26, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. John R Taylor
Title
President
Phone
(318) 742-8440

Specialties & licenses 1

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

Addresses

Primary practice location

7725 W Britton Rd
Oklahoma City, OK 73132-1507

Mailing address

2101 Highway 80
Haughton, LA 71037-9488
Phone (318) 742-8440

Other identifiers 1

IdentifierTypeStateIssuer
100645750H-G820MedicaidOK

Other names 1

  • Evergreen Presbyterian Ministries, Inc. Other name

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 6

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

Locations

7725 W Britton Rd
Oklahoma City, OK 73132
Phone (405) 720-1192

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467570051",
    "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": "318-742-8440",
            "fax_number": "318-752-5448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7725 W BRITTON RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731321507",
            "telephone_number": "405-720-1192",
            "fax_number": "405-720-1193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN OK DAILY LIVING SUPPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-742-8440",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100645750H-G820",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Presbyterian Ministries, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.