Evergreen Presbyterian Ministries, Inc.

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

NPI 1720539299 · NPPES record last updated Oct 20, 2016

Key facts

NPI
1720539299
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Practice address
15212 Wadesboro Dr.
Ponchatoula, LA 70454
Phone
(318) 949-5500
Fax
(318) 949-5555
NPI assigned
Oct 20, 2016
Organization subpart
No

Authorized official

Name
Merlon Kent Craft
Title
Executive Vice President / Cfo
Phone
(318) 949-5515

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 Yes

Addresses

Primary practice location

15212 Wadesboro Dr.
Ponchatoula, LA 70454

Mailing address

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

Other providers in Ponchatoula, LA

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

Sources for this page

Verify at the official NPI Registry.