# EVERGREEN PRESBYTERIAN MINISTRIES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Evergreen North Lake Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396095592
- **Authorized official:** MR. MERLON KENT CRAFT CPA (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (318) 949-5500

## Contact information

- **Practice address:** 45439 LIVE OAK DR, HAMMOND, LA 70401-4526
- **Practice address phone:** (318) 949-5500
- **Mailing address:** 2101 HIGHWAY 80, HAUGHTON, LA 71037-9488
- **Mailing address phone:** (318) 949-5500
- **Mailing address fax:** (318) 949-5555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | 2851 | LA | Yes |

## Other

- **Enumeration date:** 09/14/2012
- **Last updated:** 09/14/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2851 | — | LA |