NPIMap

Organization Active NPI

Evergreen Presbyterian Ministries, Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Hammond, LA
National Provider Identifier
1609014190
Registry record updated Jan 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
9957 Issued in LA
Legal business name
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Practice address
906 C M Fagan Dr
Suite 6-a
Hammond, LA 70403-6056
Phone
(985) 543-6591
Fax
(985) 543-6638
NPI assigned
Jan 22, 2009
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
John R Taylor
Title
President
Phone
(318) 949-5500

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Ok Ther Leave Vocational Support120 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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 9957 LA Primary

Addresses

NPPES NPI Registry

Primary practice location

906 C M Fagan Dr
Suite 6-a
Hammond, LA 70403-6056

Mailing address

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

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
9957MedicaidLA

Other names 1

NPPES NPI Registry
  • SELA Community Services SIL Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 22, 2009.

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232582400000",
    "number": "1609014190",
    "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": "906 C M FAGAN DR",
            "address_2": "SUITE 6-A",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704036056",
            "telephone_number": "985-543-6591",
            "fax_number": "985-543-6638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PRESBYTERIAN MINISTRIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-22",
        "last_updated": "2009-01-22",
        "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": "318-949-5500"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "LA",
            "license": "9957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9957",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SELA Community Services SIL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hammond, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.