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Evergreen Presbyterian Ministries, Inc.

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Natchitoches, LA

NPI 1710035290 · NPPES record last updated May 27, 2025

Key facts

NPI
1710035290
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
553 (LA)
Legal business name
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Practice address
195 New Town Road
Natchitoches, LA 71457
Phone
(318) 357-0920
NPI assigned
Jan 8, 2007
Organization subpart
No

Authorized official

Name
Douglas Ryland
Title
Regional Vice 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 Disabilities Intermediate Care Facility 315P00000X 553 LA Yes

Addresses

Primary practice location

195 New Town Road
Natchitoches, LA 71457

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
1717941MedicaidLA

Other names

  • Oak Grove Group Home Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 27, 2025.

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748304000000",
    "number": "1710035290",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 NEW TOWN ROAD",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "71457",
            "telephone_number": "318-357-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PRESBYTERIAN MINISTRIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-05-27",
        "certification_date": "2025-05-27",
        "status": "A",
        "authorized_official_last_name": "RYLAND",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "REGIONAL VICE PRESIDENT",
        "authorized_official_telephone_number": "318-949-5500"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "LA",
            "license": "553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1717941",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Grove Group Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Natchitoches, LA

All providers in Natchitoches, LA · Intellectual Disabilities Intermediate Care Facility in Louisiana

Sources for this page

Verify at the official NPI Registry.