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Organization
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Active
Organization
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Active
Other names
Evergreen North Lake Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MERLON KENT CRAFT CPA (CHIEF FINANCIAL OFFICER)
(318) 949-5500
Entity
Organization
Contact information
Practice address
45439 LIVE OAK DR, HAMMOND, LA 70401-4526
(318) 949-5500
Mailing address
2101 HIGHWAY 80, HAUGHTON, LA 71037-9488
(318) 949-5500
(318) 949-5555
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
2851
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2851
—
LA
Enumeration date
09/14/2012
Last updated
09/14/2012
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