NPIMap

Evergreen Presbyterian Ministries, Inc.

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

NPI 1740334283 · NPPES record last updated May 30, 2025

Key facts

NPI
1740334283
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
License
530 (LA)
Legal business name
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Practice address
98 Country Club Dr
Pineville, LA 71360-2656
Phone
(318) 640-4996
NPI assigned
Jan 22, 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 530 LA Yes

Addresses

Primary practice location

98 Country Club Dr
Pineville, LA 71360-2656

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
1717860MedicaidLA

Other names

  • Country Club Road Community Home Doing business as

Other providers in Pineville, LA

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

Sources for this page

Verify at the official NPI Registry.