NPIMap

Organization Active NPI

Evergreen Presbyterian Ministries, Inc.

Doing business as Colonel Allen Community Home

  • Intellectual Disabilities Intermediate Care Facility
  • Baton Rouge, LA
National Provider Identifier
1972649127
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
867 Issued in LA
Legal business name
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Doing business as
Colonel Allen Community Home
Practice address
14857 Colonel Allen CT
Baton Rouge, LA 70816-2912
Phone
(225) 754-7724
NPI assigned
Jan 29, 2007
Last updated
Jun 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 867 LA Primary

Addresses

Primary practice location

14857 Colonel Allen CT
Baton Rouge, LA 70816-2912

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
1714194MedicaidLA

Other names 1

  • Colonel Allen Community Home Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972649127. Details of each certification follow.

  • CCN 19G543 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 19G543

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Colonel Allen Community Home
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
May 12, 1999
Last certification
Jun 3, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
14857 Colonel Allen Court
Baton Rouge, LA 70816

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Ok Room Board Support120 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1972649127",
    "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": "14857 COLONEL ALLEN CT",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708162912",
            "telephone_number": "225-754-7724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PRESBYTERIAN MINISTRIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "318-949-5500"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "LA",
            "license": "867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1714194",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colonel Allen Community Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.