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Evergreen Presbyterian Ministries, Inc.

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Hammond, LA

NPI 1629216700 · NPPES record last updated Jan 28, 2009

Key facts

NPI
1629216700
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
9958 (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 28, 2009
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Evergreen Ok Ther Leave Vocational Support (120 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 9958 LA Yes

Addresses

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

IdentifierTypeStateIssuer
PCA 9958MedicaidLA

Other names

  • SELA Community Services PCA Doing business as

Other providers in Hammond, LA

All providers in Hammond, LA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Louisiana

Sources for this page

Verify at the official NPI Registry.