Evergreen Presbyterian Ministries, Inc.

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

NPI 1669725032 · NPPES record last updated Oct 22, 2012

Key facts

NPI
1669725032
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
2203781164 (LA)
Legal business name
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Practice address
1101 Nona St
Vinton, LA 70668-4123
Phone
(318) 949-5500
Fax
(318) 949-5555
NPI assigned
Oct 22, 2012
Organization subpart
No

Authorized official

Name
Mr. Merlon Kent Craft
Title
Cfo
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 2203781164 LA Yes

Addresses

Primary practice location

1101 Nona St
Vinton, LA 70668-4123

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
2203781164MedicaidLA

Other providers in Vinton, LA

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

Sources for this page

Verify at the official NPI Registry.